Radiosurgery is a medical procedure that allows non-invasive treatment of benign and malignant tumors. The goal of Radiosurgery is to produce clinical outcomes on par (or better than) traditional surgery, using the best technology science has to offer.
Three common terms you might hear oncologists use are (click each for more info):
- Stereotactic Radiosurgery(SRS)
- Stereotactic Body Radiation Therapy (SBRT)
- Intensity-Modulated Radiation Therapy (IMRT)
Radiosurgery is very high-dose, focused radiation, delivered with extreme precision to target only the intended tumor volumes (or lesions) while avoiding surrounding healthy organs and tissues. SRS & SBRT are acronyms often used by medical professionals referring to Radiosurgery. Radiosurgery typically is employed to address discrete tumors or lesions the size of a golf-ball or smaller. SRS & SBRT can treat many of these lesions in one treatment plan or multiple treatment plans.
Some older definitions of SRS limit its course to one fraction or treatment which today is technically incorrect. Radiosurgery can be delivered in 1-5 treatments which typically are delivered at least 24 hours apart because of the radiobiology of the disease they are treating. For instance, most GammaKnife treatments are inherently limited to one large dose (or fraction) in the brain, whereas technologies such as the CyberKnife can be divided into up to 5 treatments for clinical purposes including mitigating edema or brain swelling.
SRS (Stereotactic Radiosurgery) refers to the treatment with high-dose, focused radiation of intracranial and spinal tumors such as meningiomas, acoustic neuroma, pituitary adenoma among others (click here for more info).
SBRT (Stereotactic Body Radio Therapy) refers to the treatment with high-dose, focused radiation of Breast, Lung, Prostate, Liver , Spine, Kidney, Adrenal, Pancreatic, Bone, Abdominal and Soft-Tissue Cancers, Tumors and Lesions. SBRT can also, like SRS, be delivered in up to 5 large high-dose fractions (click here for more info).
A Radiosurgeon can prescribe Radiosurgery with either the curative care intent (ablating the tumor over time) or palliative care intent (enhancing a patient’s life by minimizing suffering) for their patients.
Radiosurgery may be employed as a first line, stand-alone modality to treat a patient or to supplement other modalities such as surgery, chemotherapy, and conventional radiation.
A specialized type of therapy called Stereotactic Radisurgery uses many focused beams, targeting a well-defined tumor aided by:
- Detailed Imaging
- Computerized 3D Treatment Planning and
- Experienced Medical Professionals
to deliver the radiation dose with extreme accuracy (i.e., stereotactically).
Is Radiation Therapy Safe?
Some patients worry about the safety of radiation therapy. Radiation has been used successfully to treat patients for more than 100 years (read about the history of radiation therapy). In that time, many advances have been made to ensure that radiation therapy is safe and effective. Before you begin receiving radiation therapy, your radiation oncology team will carefully design your plan to make sure that you receive safe and accurate treatment. The medical phycisist in the center works with the radiation oncologist to develop an extensive safety and quality assurance plan to ensure that every patient receives the right treatment in the safest possible way, each and every time.
Treatment will be carefully planned to focus on the cancer while avoiding healthy organs in the area. Throughout your treatment, members of your team check and recheck your plan. Special computers are also used to monitor and double-check the treatment machines to make sure that the proper treatment is given.
If you undergo external beam radiation therapy, you will not be radioactive after treatment ends because the radiation does not stay in your body. However, if you undergo brachytherapy, tiny radioactive seeds will be implanted into your body either temporarily or permanently.
Your radiation oncologist will explain any special precautions that you or your family may need to take for a short time following treatment.
If you are very interested in the technical aspects of radiation, here are some questions you may want to ask your radiation oncologist about the quality assurance at the clinic where you will be receiving therapy.
There are two major types of Stereotactic Radiation Treatment:
- Stereotactic Radiosurgery (SRS) refers to one or more treatments usually of the brain or spine.
- Stereotactic Body Radiation Therapy (SBRT) refers to one or more treatments with the body, most often excluding the brain or spine.
The advantage of SRS/SBRT is it delivers a focused beam of radiation, non-invasively, to the cancer in a shorter amount of time than traditional treatments. Plus the treatment is delivered with extreme accuracy, minimizing the effect on nearby organs. However, this treatment may not be suitable for all situations, so a Radiation Oncology Specialist should be consulted to discuss treatment options. Click here to contact a Colorado CyberKnife specialist today
Introduction to Radiation Oncology
Board Certified Radiation Oncologist Dr. Alan J Katz describes the history of radiation oncology, and specifically how it’s used to treat prostate cancer.
Who is Radiosurgery Appropriate for?
Radiosurgery can treat many diagnoses as a first line therapy, precluding surgery altogether, e.g. prostate cancer, certain lung cancers, many brain and spinal tumors, primary kidney, liver and adrenal tumors among others.
- Patients who do not want or refuse invasive surgery
- Patients that are medically unstable (non-surgical candidates-those with comorbidities or other medical conditions that preclude surgery)
- Patients who fail surgery (disease cannot be resected because it’s microscopic, residual, recurrent or too close to a critical structure)
- E.g. a prostate cancer patient whose PSA continues to rise after prostate surgery (prostatectomy) is a surgical failure
- E.g. a lung cancer patient whose PET scan or other medical image shows or presents recurrence 3 months after surgery (lobectomy)
- E.g. a brain cancer patient whose neurosurgeon was unable to resect or excise all of a patient’s tumor in surgery will often require radiosurgery as an adjunct treatment to improve and enhance surgical outcomes
- E.g. a breast cancer patient following lumpectomy and mastectomy who requires high-dose radiation to improve and enhance the durability of their surgical procedures
What does Radiosurgery Treat?
Radiosurgery can be a safer alternative in the treatment of many ailments and cancers from Brain Tumors (primary, gliomas, metastases, meningiomas, acoustic neuromas, arteriovenous malformations…) to Brain, Breast, Lung, Prostate, Liver , Spine, Kidney, Adrenal, Pancreatic, Bone, Abdominal and Soft-Tissue Cancers, Tumors and Lesions.
What are my Radiosurgery treatment options?
Stereotactic radiation may be delivered by a number of different devices; brand name stereotactic treatment machines you may hear mentioned include: Accuray CyberKnife and Accuray TomoTherapy, Elekta Versa HD, Elekta Gamma Knife, Novalis Tx, Proton Particle Therapy, Varian Edge, Varian Trilogy and Varian TruBeam STX and Viewray.