Clinical Practice Guidelines

One of the primary objectives of the ISRS is to elucidate best practices and provide guidance for safe and effective practice of radiosurgery and SBRT. During the past several years, a number of important intra-cranial guidelines have been published under the direction of, and with input from, global experts who form the committees. Additional guidelines are in development with a new focus on extra-cranial SBRT.
The guideline development process reflects our commitment to mentoring young professionals in the field of SRS/SBRT, as each junior guideline lead is partnered with a senior committee member to guide the process and writing of the guideline. The intent is to foster the next generation of leaders in SRS/SBRT. The ISRS is grateful for the considerable time and effort of each of the contributors. Most of the following guidelines may be accessed free of charge via open access by clicking on the publication titles.

GUIDELINE’S COMMITTEE MEMBERS

Intra-cranial committee: Sahgal A (Chair) , De Salles A, Levivier M, Paddick I, Ma L, Fariselli L, Sheehan J, Suh J, Yomo S, Regis J, Pollack B, Kotecha R (Co-Chair)

Extra-Cranial committee: A Sahgal (Chair), Lo S, Slotman B, Kim M, Tree A, Guckenberger M, Scorsetti M, Kotecha R, Louie A (Co-Chair)

ISRS GUIDELINES - EXTRACRANIAL

SPINE


 

REIRRADIATION SPINE STEREOTACTIC BODY RADIATION THERAPY (SBRT) FOR SPINAL METASTASES
Myrehaug S, Sahgal A, Hayashi M, Levivier M, Ma L, Martinez R, Paddick I, Régis J, Ryu S, Slotman B, De Salles A
J Neurosurg Spine. 2017 Jul 14:1-8.
DOI: 10.3171/2017.2.SPINE16976.

STEREOTACTIC BODY RADIOTHERAPY FOR DE NOVO SPINAL METASTASES
Husain ZA, Sahgal A, De Salles A, Funaro M, Glover J, Hayashi M, Hiraoka M, Levivier M, Ma L, Martínez-Alvarez R, Paddick I, Régis J, Slotman BJ, Ryu S
J Neurosurg Spine. 2017 Jun 9:1-8.
DOI: 10.3171/2017.1.SPINE16684.


STEREOTACTIC RADIOSURGERY FOR POSTOPERATIVE SPINE MALIGNANCY: A SYSTEMATIC REVIEW AND INTERNATIONAL STEREOTACTIC RADIOSURGERY SOCIETY PRACTICE GUIDELINES
Faruqi S, Chen H, Fariselli L, Levivier M, Ma L, Paddick I, Pollock BE, Regis J, Sheehan J, Suh J, Yomo S, Sahgal A
Pract Radiat Oncol. 2021 Oct 19:S1879-8500(21)00282-4.
DOI: 10.1016/j.prro.2021.10.004.

ISRS GUIDELINES - INTRACRANIAL

BENIGN TUMORS


 

STEREOTACTIC RADIOSURGERY FOR SECRETORY PITUITARY ADENOMAS
Mathieu D, Kotecha R, Sahgal A, De Salles A, Fariselli L, E. Pollock B, Levivier M, Ma L, Paddick I, Regis J, Yomo S, H. Suh J, Rubens M, P. Sheehan J.
J Neurosurg Spine. 2021 Sep 3.
DOI: 10.3171/2021.2.JNS204440.


STEREOTACTIC RADIOSURGERY FOR INTRACRANIAL NONCAVERNOUS SINUS BENIGN MENINGIOMA: INTERNATIONAL STEREOTACTIC RADIOSURGERY SOCIETY SYSTEMATIC REVIEW, META-ANALYSIS AND PRACTICE GUIDELINE
Marchetti M, Sahgal A, A F De Salles A, Levivier M, Ma L, Paddick I, Pollock BE, Regis J, Sheehan J, Suh JH, Yomo S, Fariselli L
Neurosurgery. 2020 May 28.
DOI: 10.1093/neuros/nyaa169


STEREOTACTIC RADIOSURGERY FOR NON-FUNCTIONING PITUITARY ADENOMAS: META-ANALYSIS AND INTERNATIONAL STEREOTACTIC RADIOSURGERY SOCIETY PRACTICE OPINION
Kotecha R, Sahgal A, Rubens M, De Salles A, Fariselli L, Pollock BE, Levivier M, Ma L, Paddick I, Regis J, Sheehan J, Yomo S, Suh JH
Neuro Oncol. 2020 Mar 5;22(3):318-332
DOI: 10.1093/neuonc/noz225


STEREOTACTIC RADIOSURGERY FOR BENIGN (WORLD HEALTH ORGANIZATION GRADE I) CAVERNOUS SINUS MENINGIOMAS - INTERNATIONAL STEREOTACTIC RADIOSURGERY SOCIETY (ISRS) - PRACTICE GUIDELINE: A SYSTEMATIC REVIEW
Lee CC, Trifiletti DM, Sahgal A, DeSalles A, Fariselli L, Hayashi M, Levivier M, Ma L, Álvarez RM, Paddick I, Regis J, Ryu S, Slotman B, Sheehan J. 
Neurosurgery. 2018 Mar 15.
DOI: 10.1093/neuros/nyy009


STEREOTACTIC RADIOSURGERY FOR VESTIBULAR SCHWANNOMA: INTERNATIONAL STEREOTACTIC RADIOSURGERY SOCIETY (ISRS) PRACTICE GUIDELINE
Tsao M, Sahgal A, Xu W, De Salles A, Hayashi M, Levivier M, Ma L, Martinez R, Régis J, Ryu S, Slotman B, Paddick I
Journal of radiosurgery and SBRT. 2017 Vol. 5 (1), 5-24.

FUNCTIONAL/EPILEPSY


 

STEREOTACTIC RADIOSURGERY FOR TRIGEMINAL NEURALGIA
Tuleasca C, Régis J, Sahgal A, De Salles A, Hayashi M, Ma L, Martínez-Alvarez R, Paddick JI, Ryu S, Slotman BJ, Levivier M.
J Neurosurg. 2018 Apr 27:1-25.
DOI: 10.3171/2017.9.JNS17545


STEREOTACTIC RADIOSURGERY FOR TREMOR
Martínez-Moreno N, Sahgal A, De Salles A, Hayashi M, Levivier M, Ma L, Paddick I, Régis J, Ryu S, Slotman B, Martínez-Álvarez R
Journal of Neurosurgery 2018 23(2) 1-12.
DOI: 10.3171/2017.8.JNS17749


RADIOSURGERY FOR EPILEPSY: SYSTEMATIC REVIEW AND INTERNATIONAL STEREOTACTIC RADIOSURGERY SOCIETY (ISRS) PRACTICE GUIDELINE
McGonigal A, Sahgal A, De Salles A, Hayashi M, Levivier M, Ma L, Martinez R, Paddick I, Ryu S, Slotman B, Régis J
Epilepsy research 2017 Vol 137 123-131.
DOI: 10.1016/j.eplepsyres.2017.08.016

MALIGNANT TUMORS


 

Stereotactic Radiosurgery for Postoperative Metastatic Surgical Cavities: A Critical Review and International Stereotactic Radiosurgery Society (ISRS) Practice Guidelines
Redmond KJ, De Salles AAF, Fariselli L, Levivier M, Ma L, Paddick I, Pollock BE, Regis J, Sheehan J, Suh J, Yomo S, Sahgal A.
Int J Radiat Oncol Biol Phys. 2021 Sep 1;111(1):68-80. doi: 10.1016/j.ijrobp.2021.04.016. Epub 2021 Apr 20.PMID: 33891979 Free article. Review.

DOI: doi.org/10.1016/j.ijrobp.2021.04.016


STEREOTACTIC RADIOSURGERY IN THE MANAGEMENT OF LIMITED BRAIN METASTASES (ONE TO FOUR)
Chao S, De Salles A, Hayashi M, Levivier M, Ma L, Martinez R, Paddick I, Régis J, Ryu S, Slotman B, Sahgal A
Neurosurgery 2017 11(3)
DOI: 10.1093/neuros/nyx522

VASCULAR DISORDERS


 

 

STEREOTACTIC RADIOSURGERY FOR DURAL ARTERIOVENOUS FISTULAS: A SYSTEMATIC REVIEW AND META-ANALYSIS AND INTERNATIONAL STEREOTACTIC RADIOSURGERY SOCIETY PRACTICE GUIDELINES
Singh R, Chen C-J, Didwania P, Kotecha R, Fariselli F, Pollock BE, Levivier M, Paddick I, Yomo S, Suh JH, Sahgal A, Sheehan JP
Neurosurgery. April 2022. Publish Ahead of Print (2)
DOI: TBA

 

STEREOTACTIC RADIOSURGERY FOR SPETZLER-MARTIN GRADE I AND II ARTERIOVENOUS MALFORMATIONS: INTERNATIONAL SOCIETY OF STEREOTACTIC RADIOSURGERY (ISRS) PRACTICE GUIDELINE
Graffeo CS, Sahgal A, De Salles A, Fariselli L, Levivier M, Ma L, Paddick I, Regis JM, Sheehan J,Suh J, Yomo S, Pollock BE
Neurosurgery. 2020 Feb 17.
DOI: 10.1093/neuros/nyaa004


ISRS GUIDELINES – INTRACRANIAL – IN DEVELOPMENT

  • Steve Braunstein, Lijun Ma. Multiple Brain Metastases (>5)
  • Ian Paddick. Technical guidelines for stereotactic radiosurgery: Treatment of small metastases
  • Christopher S. Graffeo, Bruce Pollock. High-grade SM AVM
  • Constantin Tuleasca, Marc Levivier. KOOS IV Acoustic
  • Anne Balossier, Jean Regis. KOOS 1-2 Acoustic
  • Shreya Saxena, Manmeet Ahluwalia. EGFR-m NSCLC brain mets
  • Valentina Pinzi, Laura Fariselli. Recurrent GBM
  • Bala Vellayappan, Lijun Ma, Mary Jane Lim Fat. Radiation Necrosis

ISRS GUIDELINES – EXTRACRANIAL – IN DEVELOPMENT

  • Shankar Siva, Simon Lo. Rena! Cell Carcinoma
  • Alex Louie, Ben Slotman. Ultra-central lung SBRT
  • WON-IL Jang, Mi-Sook Kim. Hepatocellular Carcinoma
  • Timothy Nguyen, Allison Tree. Non-spine bone metastases
  • Matthias Guckenberger. Lung Oligometastasis
  • Ciro Franzese, Maria Scorsetti. Liver Metastasis
  • Erin Murphy, Rupesh Kotecha. Pediatric SBRT
  • Irene Karam, Arjun Sahgal. Head and Neck SBRT