Recent Advances of Radiosurgery for Malignant Brain Tumors

Gwak, Ho-Shin; Youn, Sangmin; Rhee, Changhun

Review article

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2005;1(1):51-60.
Published online June 30, 2005.

Recent Advances of Radiosurgery for Malignant Brain Tumors

Ho-Shin Gwak, Sangmin Youn, Changhun Rhee

Department of Neurosurgery, Korea Institute of Radiological and Medical Science, Seoul, Korea

Abstract

Radiosurgery has become one of the major therapeutic modalities in the treatment of brain tumors with rapid developments of neuroimaging and robotic technology in the last two decade. Though the feature of conformal dose distribution itself made radiosurgery more suitable for benign, well-demarcated tumors such as meingioma, schwannoma etc., easy delivery of lethal dose to the tumor center in a single session confer radiosurgery an important tool for adjuvant or palliative treatment of malignant brain tumors. In the treatment for metastatic tumors, radiosurgery could be chosen as a treatment of choice in the selected patients because it provides more durable tumor control and more rapid symptom improvement in a more convenient way than conventional radiotherapy. Recurrence of metastatic brain tumor in long-term survivors calls for the practice of radiosurgery as an initial treatment to avoid radiation-induced toxicities. The infiltrative feature of malignant glioma is a major disadvantage for wide application of radiosurgery as a primary treatment. But focused radiosurgery beam is helpful to local control of radioresistant glioma as adjuvant to conventional radiotherapy and also provide more treatment options for well-demarcated recurrent lesions. In primary CNS lymphoma, radiosurgery is under investigation for being used as primary or boost to reduce the wholebrain radiation dose. Other radioresistant and locally difficult to control brain tumors, like malignant meningioma, chordoma/chondrosarcoma, delivering tumor-lethal dose has been actively tried in many radiosurgery centers and some results give us a possibility for control these tumors in the future.

Key Words: Radiosurgery, Malignant brain tumor, Metastasis, Glioma.