Stereotactic Radiosurgery for Glial Tumors

Abstract

The prognosis for patients with gliomas has not substantially improved, even with advances in imaging, neurosurgery, and neuro-oncology. Although resection remains the initial treatment of choice for most gliomas, the gross total resection is not always possible. These tumors often recur needing other forms of therapy to control the tumor growth. Stereotactic radiosurgery (SRS) offers a precise, local administration of radiation. SRS is well tolerated and is associated with a relatively low risk of adverse radiation effects (ARE) in glial tumor patients who otherwise have relatively few options. Stereotactic radiosurgery (SRS) has been offered as a primary option for unresectable low-grade gliomas (LGG) and adjuvant therapy for partially resected LGG. SRS is used as salvage therapy in patients with recurrent or residual malignant gliomas. Although randomized controlled studies are lacking, preliminary data suggest that radiosurgery may be a viable alternative for low-grade gliomas, with improved survival and a low rate of complications. Although the prognosis for malignant gliomas is poor even after radiosurgery, the radiosurgical treatment allows the surgeon more flexibility in terms of operative planning which leads to better quality of life for patients postoperatively.