Basic principles of brain tumor radiotherapy

Primary CNS neoplasms are a challenging group of tumors to treat given their varied patterns of behavior and subsequent varied clinical outcomes. This chapter will focus on the treatment of both adult low-grade gliomas (LGGs) and adult high-grade gliomas (HGGs), with an emphasis on radiation therapy techniques. We will first review the fundamental principles of radiation biology and physics. This will be followed by an in-depth explanation of the complex process of radiation planning, delivery, and toxicity management. The specifics of radiation field design for adult LGG and HGG will be outlined in detail. The chapter will conclude with a summary of surveillance imaging guidelines for adult glioma patients, treatment options for recurrent disease, and future directions in the field of radiotherapy for CNS neoplasms.