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Fractionated Radiosurgery

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Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy

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Abstract

Fractionated stereotactic radiosurgery (SRS) is emerging as an effective treatment option for relatively large intracranial tumors, with the aim of improving the balance between tumor control and normal tissue toxicity over single-fraction SRS, particularly for large lesions or lesions located in critical areas of the brain. Several published studies have reported excellent clinical outcomes and acceptable toxicity after fractionated SRS for primary and secondary brain tumors delivered with different machines, including the Gamma Knife, the CyberKnife, or a modified linear accelerator (LINAC). Current published data support the use of fractionated SRS for relatively large tumors or tumors in close proximity to critical anatomic structures, such as the optic apparatus or the brainstem, that are generally not suitable for SRS; however, future clinical and biologic research is needed to definitively establish the advantages of fractionated SRS over other radiation techniques and the optimal radiation dose and fractionation according to the different brain tumors. A critical analysis of the fundamental radiobiological principles, clinical results, and toxicity of fractionated SRS for brain tumors is presented with an attempt of defining the advantages and limits of the technique.

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Authors and Affiliations

  1. Radiation Oncology Unit, UPMC Hillman Cancer Center, San Pietro Hospital, Rome, Italy

    Giuseppe Minniti & Claudia Scaringi

  2. IRCSS Neuromed, Pozzilli, Italy

    Giuseppe Minniti

  3. Radiation Oncology Unit, Sant’Andrea Hospital, University Sapienza, Rome, Italy

    Claudia Scaringi

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  1. Giuseppe Minniti
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  2. Claudia Scaringi
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Editors and Affiliations

  1. Mayo Clinic, Radiation Oncology, Mayo Clinic School of Medicine Radiation Oncology, Jacksonville, FL, USA

    Daniel M. Trifiletti

  2. Department of Radiation Oncology, Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, USA

    Samuel T. Chao

  3. Sunnybrook Odette Cancer Centre, Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada

    Arjun Sahgal

  4. University of Virginia, Departments of Neurological Surgery and Radiation Oncology, Charlottesville, VA, USA

    Jason P. Sheehan

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Minniti, G., Scaringi, C. (2019). Fractionated Radiosurgery. In: Trifiletti, D., Chao, S., Sahgal, A., Sheehan, J. (eds) Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-16924-4_8

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  • DOI: https://doi.org/10.1007/978-3-030-16924-4_8

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