Paediatric stereotactic radiosurgery for malignant CNS tumours using CyberKnife

Although the value of stereotactic radiosurgery for the treatment of brain tumours in children is well recognized, the widespread use of stereotactic radiosurgery in paediatrics has been limited by difficulties with rigid fixation for young children, the need for general anaesthesia, and certain characteristics of some paediatric brain tumors which may promote the risk of radionecrosis. The CyberKnife radiosurgery system is both frameless and precise and therefore offers potential solutions to these problems. We review the advantages of frameless radiosurgery for paediatric patients, discuss factors specific to CyberKnife stereotactic radiosurgery for children, and report our preliminary experience with a group of 21 patients.