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14a - Photons and Particles

from Chapter 14 - High Energy Forms: Employing the Spectrum of Energy as Surgical Adjuvants

Published online by Cambridge University Press:  29 November 2025

Benjamin Hartley
Affiliation:
Weill Cornell Medical Center
Philip E. Stieg
Affiliation:
Weill Cornell Medical College
Rohan Ramakrishna
Affiliation:
Weill Cornell Medical College
Michael L. J. Apuzzo
Affiliation:
Adjunct of Yale Medical School and Weill Cornell Medical College
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Summary

The concept of radiosurgery was first introduced by Lars Leksell in 1951. Throughout the decades, the indications for stereotactic radiosurgery (SRS) and available SRS technology have expanded. Currently, SRS is indicated for selected patients with malignant and benign brain tumors such as metastases, recurrent glioblastoma and WHO Grade II meningioma, vestibular schwannoma, WHO Grade I meningioma, recurrent non-functioning and functioning pituitary adenoma. SRS is also indicated for patients with cerebral vascular malformations, cranial nerve neuralgias, and for patients suffering from obsessive compulsive disorder refractory to medications. Though the indications of SRS and the number of SRS procedures performed annually increase, SRS literature is limited mainly to retrospective studies providing low Level of evidence. Moreover, exposure to SRS procedures during neurosurgical training seems inadequate. Therefore, development of randomized studies and national or international SRS registries, and adequate training of neurosurgical residents to improve patient care is necessary.

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