63. Stereotactic radiotherapy for primary and recurrent brain tumors. A new method for improvement of the treatment results?

To evaluate the effectiveness of the stereotactic radiosurgery (SRS) and stereotactic fractionated radiotherapy in the primary, recurrent and metastatic brain tumors.To present potential usefulness of stereotactic boost in anaplastic astrocytomas (AA) and glioblastoma multiforme (GBM).Between March 2000 and December 2000, SRS was applied in 23 patients (pts) with brain tumors (metastatic tumors – 9 pts, recurrent tumors – 7 pts, primary meningiomas – 4 pts, vascular malformations – 3 pts).Fractionated stereotactic radiotherapy was applied in 6 pts (recurrent anaplastic gliomas – 2 pts, recurrent medulloblastoma – 1 pt, acustic neurinoma – 1 pt, meningioma – 1, pituitary adenoma – 1).Detailed technique of treatment planning is presented and discussed. The planning target volume (PTV) and organs at risk (OAR) were assessed comparing dose statistics, dose volume histograms and RTOG stereotactic radiosurgery criteria.Recommendations regarding the total dose level and fractional dose are proposed.The treatment tolerance and preliminary results are presented.The own protocol of stereotactic boost to residual tumor using SRS after initial conformal radiotherapy in patients with AA and GBM is presented and discussed