Stereotactic Radiosurgery in the Treatment of Glioblastoma Multiforme: Current Status of Technology and Potential Role of Microbeam Radiosurgery

Stereotactic radiosurgery is an emerging treatment option offered to patients with glioblastoma (GB). Radiosurgery is performed as an outpatient procedure and provides a safe and effective non-invasive treatment for focal GB. High-energy beams originating from cobalt sources placed into a helmet-shaped device (Gamma Knife®, Elekta) or generated by a linear accelerator (LINAC), rotating on a gantry (X-Knife®, Novalis), or maneuvered by a robotic arm (CyberKnife®, Accuray) are delivered with submillimetric accuracy to a selected intracranial target. Treatment accuracy is assured by image-guided volumetric CT and MR studies complemented with advanced metabolic neuroimaging techniques, such as PET-CT. Some authors suggest radiosurgery as a salvage treatment in patients with recurrent GB to avoid further surgical procedures or as a complement to conventional fractionated radiotherapy. This paper reviews the current role and applications of stereotactic radiosurgery in the treatment of GB, illustrating also an emerging experimental technology, microbeam radiosurgery, which is close to being welcomed into the clinical field. Categories: Radiation Oncology, Neurosurgery