Stereotactic Radiosurgery

What is stereotactic radiosurgery?

In spite of its name, stereotactic radiosurgery doesn't involve surgery at all. Rather, it is a radiation treatment used to target difficult to remove tumors such as skull base tumors or spinal cord tumors. It may also be the recommended therapy for patients who cannot tolerate surgery due to age or health condition. Sterotactic radiosurgery used on other parts of the body is called stereotactic body radiation therapy or SBRT.

The procedure uses 3D imaging and also relies on CT scanning, often combined with PET or MRI, to precisely locate the tumor and deliver targeted radiation, sometimes in a single dose, without destroying surrounding healthy tissue. The delivery of treatment may also be spaced out into multiple sessions, or fractionated stereotactic surgery (FSR). The radiation beam works the same as traditional radiation therapy, by distorting and destroying the DNA of cancer cells so the cells stop replicating and die.

The three types of radiosurgery are:

• Gamma knife – using highly focused gamma rays to target small- to medium-size tumors, usually in the brain
• LINAC or linear accelerator – using X-rays to target larger tumors outside the brain; types of LINAC include CyberKnife, X-Knife, Novalis and Peacock
• Proton beam therapy – using charged particles to precisely target oddly shaped or difficult to reach tumors

The type of radiosurgery used depends greatly on the size and location of the tumor.

What to expect from stereotactic radiosurgery

This treatment is performed on an outpatient basis and you will go home the same day. Be sure to arrange for someone to drive you home afterwards as you may be tired from the treatment. Be sure to wear comfortable clothing and leave any jewelry at home. You may also be given special instructions in advance, such as to not eat or drink anything beforehand and to not wear any make-up.

You will receive an intravenous (IV) line that delivers contrast dye, medication and fluids as needed, related to your procedure. You will feel a slight pinching and some discomfort when the needle is first inserted into your arm. During the treatment, you will be lying on a table that slides into a machine. The machine and instruments will move around you to deliver radiation. You will be able to speak to the radiosurgery team in the next room by way of a microphone in the treatment area.

Depending on the recommendation of your provider, you may need to return for additional treatments (usually no more than three to five). Your provider will continue to monitor your progress and response to the treatment and will make any additional recommendations to support recovery and healing.