Judicious and evidence-based use of radiosurgery - recommendations for low- middle income countries Authors Syed Ather Enam Department of Neurosurgery, The Aga Khan University, Karachi, Pakistan. Faiza Urooj The Aga Khan Medical College and University, Karachi, Pakistan. Kaynat Siddiqui Department of Neurosurgery, The Aga Khan University, Karachi, Pakistan. Mohammad Hamza Bajwa Department of Neurosurgery, The Aga Khan University, Karachi, Pakistan. Hafiza Fatima Aziz Department of Neurosurgery, The Aga Khan University, Karachi, Pakistan. Fatima Shaukat CyberKnife and Tomotherapy Centre, Jinnah Post Graduate Medical Centre, Karachi, Pakistan. Muhammad Waqas Saeed Baqai Department of Neurosurgery, The Aga Khan University, Karachi, Pakistan. Muhammad Shakir Department of Neurosurgery, The Aga Khan University, Karachi, Pakistan. Ahsan Ali Khan Department of Neurosurgery, The Aga Khan University, Karachi, Pakistan. Pakistan Brain Tumour Consortium: (Authors list at the end of the supplement) +92 (021) 32226443 DOI: https://doi.org/10.47391/JPMA.S3.GNO-24 Abstract Surgical removal remains the primary treatment for mostbrain tumours. However, radiosurgery presents aneffective, less invasive alternative or additional treatmentfor certain types. Our goal was to explore radiosurgery'sroles in treating various brain tumours, focussing on itsapplication in low- and middle-income countries (LMICs).We reviewed all relevant systematic reviews, metaanalyses,and guidelines to determine the most effectiveradiosurgical approaches. Additionally, we consulted apanel of experts with over ten years of experience inLMICs, such as Pakistan. For brain tumours, stereotacticradiosurgery should generally follow a confirmedhistopathological diagnosis. Exceptions include tumoursidentified through Magnetic Resonance Imaging (MRI),like Vestibular Schwannoma (VS), pre-diagnosedNeurofibromatosis type 2 (NF2), multiple typicalmeningiomas, and metastases with a known histologyfrom another site. While radiosurgery is gaining tractionas a primary and adjunct treatment in some LMICs, thelack of regional guidelines, trained personnel, andcollaboration among specialists hinders its wideradoption. Addressing these gaps is crucial for expandingradiosurgical care in these regions.Keywords: Meningeal neoplasms, neurofibromatosis,neuroma, acoustic, meningioma,Radiosurgery, brain neoplasms, magnetic resonanceimaging, pituitary tumour, glioma, vestibularschwannoma. Downloads Full Text Article Published 2024-06-09 How to Cite Syed Ather Enam, Faiza Urooj, Kaynat Siddiqui, Mohammad Hamza Bajwa, Hafiza Fatima Aziz, Fatima Shaukat, Muhammad Waqas Saeed Baqai, Muhammad Shakir, Ahsan Ali Khan, & Pakistan Brain Tumour Consortium: (Authors list at the end of the supplement). (2024). Judicious and evidence-based use of radiosurgery - recommendations for low- middle income countries. Journal of the Pakistan Medical Association, 74(3 (Supple), S201-S211. https://doi.org/10.47391/JPMA.S3.GNO-24 More Citation Formats ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver Download Citation Endnote/Zotero/Mendeley (RIS) BibTeX Issue Vol. 74 No. 3 (Supple) (2024): AKU Special Supplement: Global Neuro-Oncology Section Scoping Review License Copyright (c) 2024 Journal of the Pakistan Medical Association This work is licensed under a Creative Commons Attribution 4.0 International License.