November 2024
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Stereotactic radiosurgery and stereotactic body radiation therapy are commonly used modalities for the treatment of benign and malignant conditions in adults, with extensive literature available in regard to oncologic control and toxicity outcomes. Stereotactic radiosurgery has been used in pediatric patients as well, and the indications for offering this treatment to the pediatric patient population have increased in recent years. While these techniques have been utilized and studied for many years in pediatric patients for some conditions like arteriovenous malformation, there is a relative paucity of data for newer indications such as oligometastatic disease. In general, radiosurgery and stereotactic body radiation therapy may play an important role in the management of residual disease after resection and/or focal recurrences, and, more recently, for treatment of oligometastatic disease and consolidation of metastatic disease. Given the potential constellation of toxicities in the pediatric population, appropriate patient selection is crucial. Special considerations may be needed for patient setup and treatment planning. This chapter will review the evolving indications and the corresponding outcomes and toxicity for this treatment in the pediatric population.