Stereotactic radiosurgery

Stereotactic radiosurgery (SRS) refers to any type of extremely precise and minimally invasive procedure that delivers large doses of radiation to treat cancerous tumors or other abnormal tissues. While referred to as “radiosurgery,” this treatment does not involve surgery or anesthesia. Instead, it uses highly targeted radiation beams with laser-like precision to treat unhealthy cells while sparing nearby healthy tissue.

SRS treatment uses 3D images from MRI or CT scans to identify the area to be treated. It then delivers tiny individual beams of radiation that converge to send one powerful radiation dose to the treatment area. This targeted approach is often more effective and less invasive than some other radiation methods. Sometimes, only one SRS radiation treatment is required though you may need multiple treatments, based on your treatment plan.

Penn Medicine surgeons have been performing stereotactic radiation treatment for more than 20 years. Today, our SRS treatments include:

• CyberKnife® robotic radiosurgery
• Edge® radiosurgery
• Gamma Knife® radiosurgery
• TrueBeam® radiosurgery
• Linear accelerator-based treatments, like image-guided radiation therapy (IGRT) and intensity-modulated radiation therapy (IMRT)

Our experienced doctors will create the best stereotactic radiation plan based on your specific care needs and health history. Depending on your unique case, your team may consist of radiation oncologists, neurosurgeons, dosimetrists, radiation therapists, and nurses who all work together to create your treatment plan and provide support throughout your treatment journey.

SRS radiation was first developed to treat brain tumors and other brain abnormalities that are challenging to treat with conventional surgery. Its use has expanded to treat other types of cancerous tumors, including those of the spine, lungs, pancreas, and liver. Some patients with noncancerous brain abnormalities, such as Parkinson’s disease, epilepsy, and trigeminal neuralgia may also be candidates for stereotactic radiotherapy.

Physicians at Penn Medicine often use SRS treatments for patients with these conditions:

• Brain tumors
• Spine cancer
• Metastatic lesions in certain other areas of the body, particularly if the tumors are small
• Lung cancer

A significant amount of planning is required for stereotactic surgery. First, your doctor will review your medical history and determine the best type of SRS treatment for you. You’ll have an opportunity to ask questions about your treatment options and discuss possible risks and benefits.

Once you’ve settled on a treatment option, you may go through a simulation process to prepare and plan for treatments. You’ll lie on a treatment table and learn how to position your body in the optimal spot to receive radiation. Your care team may also outfit you with an immobilization aid to help you stay very still during treatment. During this session, your radiation therapy team will check machine settings and verify doses for radiation delivery. If you are receiving stereotactic radiosurgery for a brain condition, this planning phase may include placing your head in a special frame that is attached to your skull. This frame helps ensure that the high-dose radiation beams are directed precisely at the area receiving treatment to focus on the target area and avoid healthy tissue.

Your SRS radiation treatments usually begin within days after the planning phase is complete. At the start of each session, a radiation therapist will spend five to 15 minutes positioning you for treatment and setting up the equipment as instructed by the radiation oncologist. Once you are in the proper position, the treatment will begin. You’ll be monitored throughout each treatment session to be sure you are comfortable and remain in the optimal position. You’ll be able to talk with the radiation therapist during treatment if you have any concerns.

Depending on your treatment plan, you may receive a single radiation treatment or multiple treatments over days or weeks. Your care team will provide you with an individualized schedule. Generally, each radiation therapy session lasts about 15 to 30 minutes, though times may vary.

You’ll have appointments with your radiation oncologist at least once a week during this treatment phase so they can evaluate your response to treatment. You may need blood tests and x-rays as part of this evaluation. If you are having multiple treatments, your doctor may alter the radiation dosage from one session to the next. For example, if your tumor shrinks significantly, another simulation may be required to reset the path of the radiation beams. This allows adjustments to spare healthy tissue while treating the rest of the tumor. These appointments also give you the opportunity to discuss any side effects and ways to alleviate any discomfort you are experiencing. If side effects become severe, treatment may be put on hold to allow the tissue time to heal before continuing.

When you come to Penn Medicine, you’ll receive care from one of the most experienced radiation therapy teams in the nation. Many of our radiation oncologists are nationally or internationally recognized as leaders in the field.

You can expect expert stereotactic radiotherapy treatment from your entire care team. Our physicians are board certified or in the process of board certification by the American Board of Radiology in the specialty of radiation oncology. In addition, every member of our radiation oncology team has developed additional expertise in treating tumors in specific areas of the body. You can count on our expertise to create individualized radiation treatment plans that deliver the best possible outcomes for your unique case.