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Radiosurgery for brain tumours

BMJ 2010; 340 doi: (Published 23 June 2010) Cite this as: BMJ 2010;340:c3247
  1. Susan Short, senior lecturer in clinical oncology,
  2. Jeffrey Tobias, professor of clinical oncology
  1. 1University College Hospitals NHS Trust, London NW1 2PT
  1. s.short{at}

    Technology is still moving faster than evidence, but the tide is turning

    Radiotherapy technology has developed rapidly in the past few years, and the number of methods for delivering accurate highly conformal treatment has expanded. Highly conformal radiotherapy closely matches a high radiation dose to the tumour volume and has the advantage of being a non-invasive treatment that can be offered to many patients for whom surgery would not be feasible. It is an alternative to surgery for a variety of lesions in the central nervous system.

    Radiosurgery is highly focused radiotherapy given as a single treatment or a few treatments. It aims to ablate the tumour target while delivering very low doses to surrounding normal tissue. Historically, this has relied on frame based stereotactic approaches that can accurately localise the tumour and target the beam in three dimensional space. The most commonly used delivery device has been the multi-source cobalt system developed by Lars Leskell in 1968 and known as the gamma knife. Options now include …

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