Editorial was wrong to denigrate radiosurgery so strongly

EDITOR—Brada and Cruickshank criticise the use of radiosurgery in general and gamma knife radiosurgery in particular, apparently because of the lack of any controlled trials or robust case-control studies to show its efficacy.1 Of course controlled trials are desirable, but if treatments are withheld until data from such trials are available then few, if any, neurosurgical operations or conventional radiotherapy treatments would be carried out. David Forster and his team at Sheffield have reported studies of gamma knife radiosurgery for otherwise inoperable arteriovenous malformations and for acoustic neuromas.2 Is a controlled trial of radiosurgery needed when the end point is angiographically proved obliteration of the arteriovenous malformation or reduction of tumour volume as seen on magnetic resonance imaging? …