Postoperative Radiotherapy (PORT) [Neurosurgery Wiki]

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===== Postoperative Radiotherapy (PORT) =====

**Postoperative Radiotherapy (PORT)** refers to the administration of **radiation therapy after surgical resection** of a tumor to eliminate residual microscopic disease and reduce the risk of local recurrence.

==== Purpose ====
  * To improve **local control** by eradicating microscopic tumor remnants.
  * To reduce the **risk of recurrence**, especially in cases with:
    * Incomplete (subtotal) resection
    * High-grade or aggressive histology
    * Positive surgical margins
    * Known radiosensitive tumors

==== Timing ====
  * Typically initiated **within weeks after surgery**, once wound healing is adequate.
  * Can be part of a **multimodal treatment plan** alongside chemotherapy and systemic therapies.

==== Common Indications ====
  * High-grade gliomas
  * Brain metastases (after resection)
  * Meningiomas with atypical or malignant features
  * Solitary fibrous tumors (SFT/HPC), especially WHO Grade II–III
  * Head and neck, breast, and rectal cancers

==== Techniques ====
  * **External Beam Radiotherapy (EBRT)**
  * **Stereotactic Radiosurgery (SRS)** or **Stereotactic Radiotherapy (SRT)** for focal lesions
  * Dose and fractionation depend on tumor type, location, and resection extent.

==== Risks and Side Effects ====
  * Fatigue, alopecia, dermatitis
  * Cognitive effects (especially with brain irradiation)
  * Radiation necrosis (rare but serious)
  * Long-term endocrine or vascular effects (in specific regions)

==== Related Terms ====
  * [[Adjuvant Therapy]]
  * [[Gross Total Resection (GTR)]]
  * [[Local Control]]
  * [[Radiation Therapy]]