Stereotactic radiotherapy

What is stereotactic radiotherapy?

Stereotactic technology is an advanced form of external beam radiotherapy used to treat specific tumour or disease types with a low number of treatment sessions (typically 1 – 5), commonly located in the brain, spine, lung, liver, pancreas, kidney, prostate, as well as other areas of the body as determined by the patients oncologist.

Stereotactic radiotherapy can also be referred to as stereotactic body radiotherapy (SBRT), stereotactic ablative radiotherapy (SABR), or stereotactic radiosurgery (SRS). It is characterised by treating a well-defined volume with very high precision using a high dose of radiation and with a small number of treatment sessions. For example, a typical external beam radiotherapy treatment will be delivered using up to around 30 treatment sessions, whereas a stereotactic radiotherapy treatment will be delivered in up to 5 treatment sessions.

It can be used to treat both primary disease and metastatic disease (sometimes referred to as secondary tumours). These are tumours that have spread from other organs in the body and cancers in the brain, spine, bones, liver and lung.

Brain cancers

Stereotactic radiation therapy is most commonly used to treat secondary tumours in the brain. Stereotactic radiation therapy is also used to treat some benign (non-cancerous) tumours such as meningiomas, pituitary adenomas and acoustic neuromas as well as some blood vessel conditions such as arteriovenous malformations.

Stereotactic radiation therapy for the brain involves the making of a customised mask that will be used during treatment to ensure the patient’s head does not move during treatment allowing the machine to precisely target the tumour.

Compared to traditional radiation therapy for metastatic disease to the brain which involves treating the entire brain, stereotactic radiation therapy only targets the individual metastatic tumours with high doses. This provides less radiation to healthy brain tissue, reduces the chance of adverse intellectual function, reduces the impact of side effects (e.g. hair loss and headaches) providing improved quality of life for patients.

At Bowen Icon Cancer Centre we use state-of-the-art technologies which can deliver treatment to multiple brain tumours at one time. This reduces the need to treat multiple tumours separately, resulting in a much shorter treatment time for patients.

Lung cancers

Stereotactic radiation therapy to the lung is most commonly used to treat early stage primary lung cancer or metastatic tumours that have spread from other organs in the body.

Stereotactic radiation therapy for lung cancer involves the use of specialised equipment to ensure the accurate representation of your breathing motion. During your simulation or CT appointment, the radiation therapists will monitor and record your breathing pattern so that we can replicate it each day for treatment. By knowing exactly where the tumour moves during your breathing cycles, we can reduce the amount of healthy lung being irradiated by focusing and targeting the treatment beams precisely at the moving tumour.

Liver cancers

Stereotactic radiation therapy to the liver is most commonly used to treat primary liver tumours. However, it can also be used to treat secondary cancers in the liver where suitable.

Stereotactic radiation therapy for liver cancer involves the use of specialised equipment to ensure the accurate delivery of treatment. Your oncologist will organise for some markers to be implanted into your liver prior to treatment. This allows us to monitor the exact position of the tumour during treatment, ensuring the tumours are precisely identified and targeted, allowing the surrounding healthy liver to have minimal exposure to radiation during treatment.

Using our auto beam hold technology, if the machine detects that the markers move outside of the treatment beam, the beam will automatically switch off. The treatment will only proceed when the tumour is within the treatment beam.

Spine

Stereotactic radiation therapy to the spine is used to treat metastatic tumours that have spread from other organs in the body to the vertebrae. Your oncologist will use both your MRI scan and planning CT scan to a very high level of accuracy.

Given the proximity of the vertebrae bodies to the spinal cord, we use highly specialised immobilisation devices – ensuring patients remain in the exact same position, state-of-the-art delivery techniques and pre-treatment CT scans to ensure that treatment every day is pinpoint accurate.

Bones

Stereotactic radiation therapy can be used to treat tumours that have spread to bones within the body. Depending on which bone we are looking to treat, your oncologist and radiation therapists will develop and customise a treatment technique that is personalised to your needs.

Prostate

Stereotactic radiation therapy can be used to treat advanced prostate cancer where the disease has started to spread to other parts of the body. Traditionally patients would be treated with hormone therapy and chemotherapy, which are often associated with negative side effects. Icon Group’s recent TRANSFORM study, published in the International Journal of Cancer, found that stereotactic radiation therapy can delay progression to these more toxic treatments for more than two years.