What is stereotactic radiosurgery?
Stereotactic radiosurgery is a way to deliver radiation to tumors or other abnormalities deep in the brain or other hard-to-reach areas of the body.
Stereotactic radiosurgery (SRS) is a radiation treatment that uses focused delivery of radiation in high doses to precise locations in the body. It is used to treat certain tumors and other abnormalities of the brain, spine, neck, lungs, liver, etc.
Swedish neurosurgeons first developed SRS in the 1950s to treat small tumors located deep in the brain with minimal damage to the nearby healthy tissue. Now, doctors use it to treat any part of the body where tumors are hard to reach or close to vital organs. SRS may also be called “stereotactic body radiotherapy” when performed on areas other than the brain and spine.
How does stereotactic radiosurgery work?
SRS is noninvasive and not a surgical operation in the traditional sense. It delivers high doses of radiation precisely targeted at the tumor. It damages the DNA of the tumor cells and stops them from reproducing, which makes the tumors gradually shrink.
While SRS on the brain or spine is usually performed in a single session, treatment of other areas in the body may take three to five sessions.
What are the types of stereotactic radiosurgery?
There are three different techniques of SRS. The radiation is delivered using one of the following:
- a gamma knife unit
- a linear accelerator
- proton beams
Why is stereotactic radiosurgery performed?
SRS is a preferred method of treatment for tumors in hard-to-reach places and for certain rare conditions, because it is a minimally invasive and precisely focused treatment. Following are some of the conditions for which SRS is performed:
Brain tumors such as
- acoustic neuroma
- low-grade astrocytoma
- pineal tumor
- malignant glioma
Other benign growths and cancers such as
- Pituitary adenoma
- Glomus tumor
- Uveal melanoma
- Brain metastasis or secondary brain cancer
- Residual tumors after surgery
- Tumors of other organs including lung, liver, etc.
- Arteriovenous malformation
- Trigeminal neuralgia
- Epilepsy and other seizure disorders
- Tremors caused by diseases such as Parkinson’s
How is stereotactic radiosurgery performed?
SRS is usually an outpatient procedure, but it might take a whole day though the actual procedure may take an hour or more.
Before the SRS a patient needs to
refrain from eating and drinking starting at 12 a.m. on the day of the treatment,
check with the doctor if their regular medications may be taken, and
inform the doctor if they have any implanted devices.
SRS involves a lot of CT and MRI imaging to precisely locate the tumor. A specialized team of doctors work together to perform the SRS, including a radiation oncologist and a neurosurgeon.
SRS is mostly done without general anesthesia except in children.
An intravenous (IV) line might be attached to the patient to keep them hydrated with fluids.
For a brain-related SRS a headframe is attached to the patient’s head with 4 pins to keep it immobile.
A soft mask may be placed on the face in case doctors need to protect it from the radiation.
The patient must lie still during the procedure, but will be able to talk to the attending doctors through the microphone.
The doctors monitor the procedure on imaging screens to deliver the radiation to the precise location.
The patient will be under observation for up to two hours after the procedure, sometimes longer.
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What are the side effects of stereotactic radiosurgery?
Side effects of SRS include:
The following rare complications may occur:
- brain swelling
- nerve pain
- death of healthy tissue (radiation necrosis)
- injury to blood vessels
Does stereotactic radiosurgery work?
SRS is an effective noninvasive treatment for certain tumors and conditions. This minimizes the risks and recovery time, and damage to healthy tissue. The efficacy of SRS also depends on the condition being treated and the stage of disease.