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 most
brain tumours. However, radiosurgery presents an
effective, less invasive alternative or additional treatment
for certain types. Our goal was to explore radiosurgery's
roles in treating various brain tumours, focussing on its
application in low- and middle-income countries (LMICs).
We reviewed all relevant systematic reviews, metaanalyses,
and guidelines to determine the most effective
radiosurgical approaches. Additionally, we consulted a
panel of experts with over ten years of experience in
LMICs, such as Pakistan. For brain tumours, stereotactic
radiosurgery should generally follow a confirmed
histopathological diagnosis. Exceptions include tumours
identified through Magnetic Resonance Imaging (MRI),
like Vestibular Schwannoma (VS), pre-diagnosed
Neurofibromatosis type 2 (NF2), multiple typical
meningiomas, and metastases with a known histology
from another site. While radiosurgery is gaining traction
as a primary and adjunct treatment in some LMICs, the
lack of regional guidelines, trained personnel, and
collaboration among specialists hinders its wider
adoption. Addressing these gaps is crucial for expanding
radiosurgical care in these regions.
Keywords: Meningeal neoplasms, neurofibromatosis,
neuroma, acoustic, meningioma,
Radiosurgery, brain neoplasms, magnetic resonance
imaging, pituitary tumour, glioma, vestibular
schwannoma.

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

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