Dose selection in stereotactic radiosurgery

Abstract

Selection of the prescription dose for radiosurgery is the final step in treatment planning. Dose selection should take into account the expectation of treatment success (i.e., tumor control, arteriovenous malformation [AVM] obliteration, and so forth) and complication risks at various doses. Accurately predicting complication risks for individual patients is a complex process that is highly dependent on the radiosurgery treatment volume, the target location, and the nature of the target tissue. Dose-response data for desired outcomes of radiosurgery are sparse and difficult to interpret for most indications, with perhaps the exception of AVM obliteration. This article reviews the principles governing dose-selection and the evolving body of data guiding dose selection in radiosurgery.