Stereotactic Radiosurgery for Low-Grade Gliomas.

Abstract

Low-grade gliomas represent a heterogeneous group of tumors. The goals of treatment include prolonged survival and reduced morbidity. Treatment strategies vary depending upon tumor histology, anatomic location, age, and the general medical condition of the patient. Safe surgical resection remains the first choice for the treatment of resectable tumors. In cases of unresectable lesions, adjuvant radiotherapy and chemotherapy are considered. Several reports in recent years have documented the safety and effectiveness of stereotactic radiosurgery (SRS) in controlling tumor growth and improving patients' survival for patients with low-grade gliomas. Patients with progressive, pilocytic, or grade 2 fibrillary astrocytomas, located in critical or deep areas of the brain, are ideal candidates for radiosurgery. The use of SRS as part of multimodal therapy for progressive, recurrent, or unresectable pilocytic or WHO grade 2 fibrillary astrocytomas is a safe and promising therapeutic modality. Gamma Knife radiosurgery has progressively gained more relevance in the management of low-grade gliomas.