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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.