Fractionated Radiosurgery

  • Giuseppe Minniti
  • Claudia Scaringi


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.


Stereotactic radiosurgery Hypofractionated radiotherapy Meningiomas Pituitary adenomas Acoustic schwannomas Brain metastases Gliomas 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Giuseppe Minniti
    • 1
    • 2
  • Claudia Scaringi
    • 1
    • 3
  1. 1.Radiation Oncology Unit, UPMC Hillman Cancer Center, San Pietro HospitalRomeItaly
  2. 2.IRCSS NeuromedPozzilliItaly
  3. 3.Radiation Oncology UnitSant’Andrea Hospital, University SapienzaRomeItaly

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