Glioma Stereotactic Radiosurgery [Neurosurgery Wiki]

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====== Glioma Stereotactic Radiosurgery ======

[[Glioma]]s is a relatively new [[indication]] for [[stereotactic radiosurgery]] (SRS). Traditionally, SRS has been considered to be an inadequate treatment for glial tumors as these are diffuse tumors, but SRS is a highly focused treatment. Tumor delineation can be challenging given the diffuse nature of the gliomas. It has been recommended to include the [[T2]]/fluid-attenuated inversion recovery ([[FLAIR]]) altered signal intensity areas in addition to the contrast-enhancing part in the treatment plan of [[glioblastoma]] in order to increase the coverage. Some have recommended including 5 mm margins to cover up for the diffusely infiltrative nature of the [[glioblastoma]]. The most common indication of SRS in patients with glioblastoma is tumor recurrence. SRS has also been used as a boost to the residual tumor or tumor bed after surgical excision before conventional radiotherapy. The addition of bevacizumab has been recently tried along with SRS in patients with [[recurrent glioblastoma]] to decrease [[radiation]] [[toxicity]]. Besides, SRS has also been used in patients with [[low-grade glioma]]s following recurrence. [[Brainstem glioma]]s, which are usually low-grade gliomas, are another indication of SRS. Outcomes following the use of SRS are comparable with [[external beam radiotherapy]] in brainstem gliomas, whereas the risks of radiation-induced complications are less. SRS has also been used in other glial tumors such as [[ganglioglioma]]s and [[ependymoma]]s
((Garg K, Agrawal D. Role of Stereotactic Radiosurgery in Glial Tumors. Neurol India. 2023 Mar-Apr;71(Supplement):S207-S214. doi: 10.4103/0028-3886.373633. PMID: 37026354.)).

see [[Glioblastoma Stereotactic Radiosurgery]]
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