Trends in cranial radiotherapy: A single-institution experience highlighting the role of stereotactic radiosurgery
Himanshi Avinash Jain, Puneet Kumar Bagri, Amruta Tripathy, Sundaram PillaiAbstract
Background:
Brain metastases represent the most common intracranial neoplasms in oncologic practice, contributing significantly to cancer-related morbidity and mortality. With advances in neuroimaging, early diagnosis of oligometastatic disease has increased, expanding the role of stereotactic radiosurgery (SRS) in management. This study aimed to analyze the demographic and clinical profile of patients receiving cranial radiation therapy at our institution, with special focus on those treated with SRS or fractionated SRS (fSRS).
Materials and Methods:
A retrospective review was conducted of all patients who received radiation therapy for primary brain tumors or brain metastases between February 2019 and July 2025. Among them, a focused subgroup of 49 patients (56 lesions) treated with SRS/fSRS between February 2019 and July 2024 was separately analyzed. Demographic data, histology, treatment intent, radiation technique, and dose details were extracted and summarized.
Results:
Out of 5635 patients treated with radiation during the study period, 323 (5.7%) underwent cranial radiation—113 (2%) for primary brain tumors and 210 (3.7%) for brain metastases. Volumetric modulated arc therapy (VMAT) was the most frequently used technique (82%). The SRS/fSRS subset (49 patients) included 10% benign lesions and 90% metastases. Lung carcinoma was the most common primary carcinoma (34.7%), followed by breast carcinoma (22.4%). Supratentorial lesions accounted for 63.3% of all targets. About 57.1% of patients received single-fraction SRS (12–25 Gy), 30.6% underwent fSRS (24–50 Gy in three to five fractions), and 12.2% had both modalities for multiple lesions.
Conclusions:
This institutional audit highlights evolving patterns of cranial radiation therapy. Brain metastases, especially from lung and breast cancers, remain the predominant indication. Most patients underwent VMAT-based or SRS techniques, reflecting the growing adoption of precision radiotherapy in neuro-oncology practice.