New trends in the radiotherapy of brain neoplasms

Improved local control and survival within an acceptable toxicity represents a difficult goal in the treatment of brain neoplasms. There are numerous staging problems and alternative therapies, therefore comparisons are difficult. Treatment planning optimization, especially with dedicated software in stereotactic radiotherapy and the use of sophisticated systems of dose delivery as multi-leaf collimator, micro-multi leaf collimator, intensity-modulated tomotherapy etc. suggests a broad range of therapeutic options with the predominant use of: a) computers; b) different strategies as high dose gradient and combination with chemotherapy; c) higher costs for specialist equipment and activity.