Transforming Brain Tumor Care: The Global Impact of Radiosurgery in Multidisciplinary Treatment Over Two Decades

Stereotactic radiosurgery, a minimally invasive treatment delivering high doses of radiation to a well-defined target, has transformed interdisciplinary treatment paradigms since its inception. This study chronicles its adoption and evolution for brain cancer and tumors globally.

A systematic literature review of SRS-focused articles from 2000 to 2023 was conducted. Literature impact was evaluated using citation counts and relative citation ratio scores. Extracted data were dichotomized between US and international publications.

Out of 5424 articles eligible, 538 met inclusion criteria reporting on 120,756 patients treated with SRS for brain cancer and tumors since 2000. Over time, publication rates grew significantly (p = 0.0016), with 56% of principal investigators based in the United States. Clinical articles accounted for 87% of the publications, with the remainder focused on technological advances. Relative to international studies, US publications had larger median samples (74 vs. 58, p = 0.012), higher median citations (30 vs. 19, p < 0.0001) and higher relative citation ratio scores (1.67 vs. 1.2, p < 0.00001). Gamma Knife and LINAC had roughly equal representation in US and international publications. Neurosurgery specialists authored more Gamma Knife-based articles, and radiation oncology specialists authored more LINAC-based papers (p < 0.0001). The most treated tumors were metastases (58%), skull base tumors (35%), and gliomas (7%). Radiographic control was achieved in 82% of metastatic tumor cases, with a 12% median complication rate.

SRS has been widely adopted both nationally and globally and continues to be a growing field. This study corroborates the clinical efficacy of SRS and reinforces its critical role in the multidisciplinary treatment of patients with brain tumors and cancer.