Radiobiology of brain metastasis: applications in stereotactic radiosurgery.
Stereotactic radiosurgery is a neurosurgical modality in which a target lesion can be irradiated while sparing normal brain tissue. In some respects, brain metastasis is well suited for radiosurgery, as metastatic lesions tend to be small and well circumscribed and displace (but do not infiltrate) normal brain tissue, facilitating the delivery of radiation. Advances in stereotactic radiosurgical planning, such as blocking patterns and beam shaping, have allowed further targeting of discrete lesions while minimizing the effect of radiation toxicity on the central nervous system. In this paper the authors review the radiobiology of brain metastases and stereotactic radiosurgical approaches that can be used to treat these tumors safely.
Jagannathan
Jay
J
Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia 22908, USA. jj5a@virginia.edu
Sherman
Jonathan H
JH
Mehta
Gautam U
GU
Chin
Lawrence S
LS
D001921:Brain / Q000503:physiopathology / Q000528:radiation effects; D001932:Brain Neoplasms / Q000556:secondary* / Q000601:surgery*; D016923:Cell Death / Q000528:radiation effects; D006801:Humans; D009362:Neoplasm Metastasis / Q000628:therapy*; D009410:Nerve Degeneration / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods / Q000592:standards; D011829:Radiation Dosage; D011839:Radiation, Ionizing; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods* / Q000592:standards