Abstract
Stereotactic radiosurgery (SRS) and hypofractionated stereotactic radiotherapy (hfSRT) using linear accelerators (LINACs) have become increasingly common treatment modalities for intracranial neoplasms. This chapter provides an overview of the history, principles, techniques, clinical applications, and quality assurance considerations for LINAC-based SRS and hfSRT. The evolution of LINAC technology and treatment planning capabilities have enabled high-quality SRS and hfSRT treatments that are dosimetrically equivalent to Gamma Knife radiosurgery, even for complex cases like multiple brain metastases. Frameless immobilization, high-resolution image guidance, and six degree of freedom alignment have facilitated precise and efficient treatments. Clinical evidence supports the use of LINAC-based SRS and hfSRT for various benign and malignant intracranial tumors, with high rates of local control and acceptable toxicity. A comprehensive quality assurance program is essential to ensure safe and effective radiosurgical treatments. As indications for SRS continue to expand and more radiotherapy centers adopt these techniques, LINAC-based SRS and hfSRT will play an increasingly important role in the management of intracranial neoplasms.