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Stereotactic Radiosurgery: A Precise Therapy for Brain Tumors

Stereotactic radiosurgery, or SRS, is a highly accurate, no-knife therapy that has transformed the treatment of central nervous system tumors. If you have been diagnosed with a brain tumor, stereotactic radiosurgery may help you avoid an open surgery procedure.

Stereotactic radiosurgery offers an additional treatment option for people whose tumors are hard to reach through surgery or who are not surgical candidates. Read on to find out how stereotactic radiosurgery is different from ordinary radiation therapy, who makes a good candidate, and what benefits and side effects you can expect.

What Is Stereotactic Radiosurgery?

Despite its name, stereotactic radiosurgery is not a surgery. Instead, a radiation oncologist targets beams of energy from different angles to meet exactly at your tumor’s location. This means the tumor gets a lot of radiation while the surrounding tissue gets very little. The effect is like a surgery, affecting only the intended area.

Stereotactic radiosurgery uses advanced energy types to target and treat conditions with precision. Common types of stereotactic radiosurgery you may hear about include:

  • Gamma Knife radiosurgery, which uses focused gamma rays for precise treatment
  • Proton beam therapy, which employs high-energy protons to target affected areas with minimal impact on surrounding tissue
  • The CyberKnife System, which delivers high-energy X-rays using a linear accelerator ( linac)

Your treatment team plans your procedure carefully using imaging such as an MRI or a CT scan to make sure your cancer is targeted with pinpoint accuracy. While stereotactic radiosurgery usually takes only one session, treatments may be split so the radiation dose is divided into several smaller doses. This process of dividing doses among several sessions is called fractionated stereotactic radiosurgery.

What Is the Difference Between Radiotherapy and SRS for Brain Tumors?

Whole-brain radiotherapy, which permeates your whole brain, was a standard treatment for metastatic brain cancer for decades. Today, however, stereotactic radiosurgery is often preferred because it targets a specific area with clearly defined boundaries.

These forms of radiation treatments have several other important differences.

  • Head frame: For stereotactic radiosurgery, you may need a head frame to help you keep still.
  • Treatment frequency: You get whole-brain radiotherapy over several treatment sessions, while stereotactic radiosurgery often requires a single session. Large tumors may need more sessions.
  • Treatment time: Whole-brain radiation lasts just a few minutes, while stereotactic radiosurgery may last one or more hours.
  • Tumors treated: Stereotactic radiosurgery can treat a single or a limited number of tumors. Whole-brain radiotherapy may be more appropriate if you have numerous or very large tumors.

Which Brain and Spine Tumors Are Best Suited for SRS?

Your radiation oncologist may use stereotactic radiosurgery to treat cancers, including:

  • Brain metastases (cancer spread to your brain from other locations)
  • Hemangioblastomas
  • Meningiomas
  • Pituitary tumors
  • Primary gliomas
  • Vestibular schwannomas

Other Brain and Spine Conditions Treated With SRS

Stereotactic radiosurgery can treat more than brain tumors. Radiation oncologists may use it to treat other conditions related to your central nervous system, such as:

  • Arteriovenous malformations
  • Cavernomas
  • Dural arteriovenous fistulas
  • Tremors
  • Trigeminal neuralgia
  • Vertebral metastases (cancer that has spread to your spine from other locations)

Who Is a Candidate for SRS?

Not everyone is eligible for stereotactic radiosurgery. Sometimes this is because other treatments might work better for you. However, stereotactic radiosurgery is an excellent option if you have a hard-to-reach or recurring cancer.

You may be a candidate for stereotactic radiosurgery if you:

  • Cannot have traditional surgery due to poor health
  • Have already received radiation therapy for a tumor
  • Have cancer that has spread to your brain from somewhere else (brain metastasis)
  • Have tumors near vital areas, such as your brain’s speech centers
  • Have tumors that are hard to reach through surgery
  • Still have tumors left after surgery

How Successful Is SRS for Brain Tumors?

The success of stereotactic radiosurgery depends on the condition being treated and many other factors. For primary brain cancers (those that start in your brain), stereotactic radiosurgery has very good success at destroying tumors or stopping their growth. This is known as the control rate.

Some control rates for stereotactic radiosurgery include:

  • Meningiomas: 90%–98%
  • Pituitary adenomas: 91%–99%
  • Vestibular schwannomas: 92%–100%

For cancer that has spread to the brain, stereotactic surgery has about the same success rates as whole-brain radiation therapy, measured in terms of whether your cancer returns and how long you typically live after surgery.

However, stereotactic radiosurgery may have a lesser impact on your brain. Whole-brain radiotherapy can cause serious problems with cognitive function, or how well you think and remember. Having stereotactic radiosurgery versus whole-brain radiotherapy is less damaging to your cognitive function in the months after surgery.

What Are the Side Effects of SRS?

Like any cancer therapy, stereotactic radiosurgery can have side effects. During or soon after your treatment, you may experience:

  • Fatigue
  • Headaches
  • Sleepiness

Fewer than 5% of patients experience complications, which might include:

  • Brain swelling
  • Neurological problems
  • Tissue death

Key Takeaways

Stereotactic radiosurgery can shrink or destroy hard-to-reach tumors with high intensity while delivering a low dose of radiation to healthy tissue. It may sound scary, but it has many advantages to consider:

  1. It’s delivered in one or just a few treatment sessions.
  2. It lacks the cognitive side effects associated with other kinds of brain radiation.
  3. For tumors that start in the brain—rather than spreading there—it offers a high success rate.

With a compassionate care team and highly skilled radiation oncologists, Capital Health Cancer Center can help you find the cancer treatment that offers the best hope for success. Request a consultation today.