biomedicines Review Proton and Heavy Particle Intracranial Radiosurgery Eric J. Lehrer 1, Arpan V. Prabhu 2 , Kunal K. Sindhu 1 , Stanislav Lazarev 1, Henry Ruiz-Garcia 3, Jennifer L. Peterson 3, Chris Beltran 3, Keith Furutani 3, David Schlesinger 4, Jason P. Sheehan 4 and Daniel M. Trifiletti 3,* 1 Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
[email protected] (E.J.L.);
[email protected] (K.K.S.);
[email protected] (S.L.) 2 Department of Radiation Oncology, UAMS Winthrop P. Rockefeller Cancer Institute University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
[email protected] 3 Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL 32224, USA;
[email protected] (H.R.-G.);
[email protected] (J.L.P.);
[email protected] (C.B.);
[email protected] (K.F.) 4 Department of Neurological Surgery, University of Virginia, Charlottesville, VA 22903, USA;
[email protected] (D.S.);
[email protected] (J.P.S.) * Correspondence: Trifi
[email protected]; Tel.: +1-904-953-1000 Abstract: Stereotactic radiosurgery (SRS) involves the delivery of a highly conformal ablative dose of radiation to both benign and malignant targets. This has traditionally been accomplished in a single fraction; however, fractionated approaches involving five or fewer treatments have been delivered for larger lesions, as well as lesions in close proximity to radiosensitive structures. The clinical utilization of SRS has overwhelmingly involved photon-based sources via dedicated radiosurgery ® ® platforms (e.g., Gamma Knife and Cyberknife ) or specialized linear accelerators.