Conventional fractionated radiation therapy vs. radiosurgery for selected benign intracranial lesions (arteriovenous malformations, pituitary adenomas, and acoustic neuromas)

摘要: Despite growing interest in radiosurgery, the precise role of radiosurgery relative to that conventional fractionated external-beam radiation therapy is not fully clear. A critical review available data suggests both a safe and effective treatment for small arteriovenous malformations, pituitary adenomas acoustic neuromas. For effectiveness clearly reduced as size malformation increases. Conventional also an neuromas, while results malformations are less encouraging. However, most have been treated with were large received relatively low doses radiation. Onc can speculate high (≥50 Gy) may be malformations. Differences apparent partly due patient selection. single fraction approximately 20 Gy (a dose frequently used during radiosurgery) probably ‘biologically equivalent’ 50 110 (at 2 Gy/fraction based on linear quadratic model). In this regard, just means escalation. It remains shown possible benefit could achieved by simply escalating Further clinical experience needed better define radiosurgery. Randomized trials comparing vs. at equal complication levels possible.