Stereotactic radiosurgery (SRS) and stereotactic radiation therapy (SRT) for neurooncological and neurological diseases: state of the art and future perspectives

Abstract

Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (SRT) are well established in a high number of neurooncological and neurological lesions. Modern technologies discussed in this review, especially the integration of multimodality imaging in the daily clinical routine, will further improve the results of SRS and SRT. Currently, the different technical methods used are comparable regarding the clinical results in different clinical indications. The technological advances allow high treatment flexibility, and therefore, new treatment indications can be established based on the new technologies. In the future, it has to be defined more clearly whether a single fraction, hypofractionated concepts, or fractionated stereotactic radiotherapy is more effective regarding the clinical results and side effects of the therapy. The main area of development for radiosurgery will be stereotactic body radiosurgery. More randomized clinical studies for all possible indications are needed in the next few decades in order to establish radiosurgery more precisely, and also to determine its true value, especially in normal-fractionated radiotherapy. In technological development, the next step has been completed and proton or particle based stereotactic radiosurgery may have increased use in the future.