Fractionated stereotactic treatment is preferable for lesions such as pituitary adenomas, acoustic neuromas, and other lesions close to sensitive structures such as the optic chiasm and the brain stem. Another advantage of fractionation is that it allows physicians to structure the field of radiation into different shapes. Ruffer said that a fractionated approach dramatically decreases side effects by reducing the daily dose. Fractionated stereotactic radiotherapy utilizes well known radiobiologic principles which allow normal tissue to tolerate greater total doses of radiation when given in smaller, daily fractions. More sophisticated targeting techniques such as field shaping and beam weighting to preferentially treat the tumor and maximally spare normal tissue will lessen that statistic even more.
Some patients also experience fatigue and some swelling.
Ruffer emphasized that for some lesions, such as vascular malformations, hemangioblastomas, and metastatic boosts, the preferred treatment is still radiosurgery. In those cases, surgeons continue to utilize the invasive head frame and give very high dose radiation to an extremely well-defined area. An important advantage of both radiotherapy and radiosurgery is recovery time. The average time for craniotomy patients is a month. Pediatric Concerns Sparing surrounding tissue, particularly in children, is essential.