Stereotactic Radiosurgery: Indications and Outcomes in Central Nervous System and Skull Base Metastases

The most recent advances in the management of systemic cancer disease have likely led to an increase in the number of patients with brain metastases. In this setting, stereotactic radiosurgery (SRS) has risen as a mainstay treatment in the management of patients diagnosed with metastatic brain lesions. Given its favorable toxicity profile over conventional radiotherapy, a continuously growing body of prospective randomized data has allowed SRS to extend the reach of local therapy both as adjuvant and/or definitive treatment of brain metastases. Conventional indications such as postoperative resection cavity SRS as well as novel approaches such as hypofractionation and preoperative SRS will be discussed in this chapter in an attempt to optimize patient selection and improve both oncologic control and quality of life.