Stereotactic Radiosurgery: From Incision to Precision

Stereotactic radiosurgery (SRS), stereotactic radiotherapy (SRT), and stereotactic body radiotherapy (SBRT) are advanced forms of stereotactic radiation therapy that have significantly transformed modern radiation oncology by enabling the delivery of highly conformal, ablative radiation doses to well-defined targets with sub-millimetric precision while minimising radiation exposure to surrounding critical structures. Initially developed for intracranial disorders, stereotactic techniques have evolved considerably with advances in patient immobilisation, image guidance, treatment planning, motion management, and radiation delivery technologies, resulting in their expanding application across a wide range of benign and malignant intracranial and extracranial diseases. Despite these advantages, SRT remains technically demanding and is associated with limitations related to lesion size, target delineation, organ motion, treatment cost, and the need for specialised multidisciplinary expertise. Ongoing technological developments, prospective clinical evidence, multidisciplinary decision-making, and stringent quality assurance are expected to further establish and expand the role of SRT in contemporary radiation oncology. This review discusses the fundamental principles, technological requirements, treatment workflow, radiobiological basis, clinical applications, advantages, limitations, and future directions of SRT.