Advancing Intracranial Tumor Treatment Through Gyroscopic Radiosurgery-Based Lattice Therapy: Evidence From a Case Series Study
Abstract
Lattice radiotherapy (LRT), a modern form of spatially fractionated radiation therapy, introduces a novel therapeutic strategy by delivering high-dose vertices interspersed within the gross tumor volume (GTV), leveraging both direct cytotoxicity and immune-mediated effects. While this technique has been explored in extracranial malignancies, its clinical application in intracranial tumors remains scarce. This study presents a preliminary case series assessing the feasibility, safety, and early clinical outcomes of LRT delivered via the gyroscopic radiosurgery platform ZAP-X® (ZAP Surgical Systems, Inc., San Carlos, USA) in patients with recurrent glioblastoma multiforme (GBM) who had already undergone multiple courses of radiotherapy. Between December 2024 and February 2025, four patients with histologically confirmed GBM received single-fraction LRT with a prescribed dose of 20 Gy to each lattice vertex. Patient-specific lattice geometries were generated using a custom Python-based software tool, ensuring high-dose spheres were fully confined within the GTV and spaced to achieve a peak-to-valley dose ratio of 4. Treatment plans were created on the ZAP-X system using multi-isocenter targeting and optimized to deliver a mean GTV dose exceeding 5 Gy. The tumor volumes of the four presented cases were 186 cc, 68 cc, 75 cc, and 293 cc. Treatment delivery times ranged between 44 and 46 minutes. All patients were evaluated clinically and radiologically at 1 and 3 months…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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