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Alternative Names
Gamma knife; CyberknifeDefinition Return to top
Stereotactic radiosurgery is a form of radiation therapy that focuses high-powered x-rays onto a small area. Despite its name, it is not considered a surgical procedure.
Description Return to top
Stereotactic radiosurgery is a form of radiation therapy. Regular radiation therapy directs radiation to the tumor and nearby tissue. Stereotactic radiosurgery more precisely focuses radiation onto the abnormal area.
It is often used to slow down the growth of small, deep brain tumors that are hard to remove during surgery. Such therapy may also be used in patients who are unable to have surgery, such as the elderly or those who are very sick. Radiosurgery may also be used after surgery to treat any remaining abnormal tissue.
Before the actual treatment, you will have MRI or CT scans taken. Using these images, a computer creates a 3-D map of the tumor area. This planning process helps your neurosurgeon and radiation oncologist to determine the specific treatment area.
During treatment, you will lie on a table, which slides into a machine that delivers radiation beams. The machine may rotate around you while it works.
For certain procedures, a head frame may be attached to your skull to keep you very still during therapy, or a plastic face mask may be used. However, improved methods that reduce the need for head frames have been developed. Because of this, tumors outside the brain, such as lung cancer, can now be treated with stereotactic radiosurgery, as long as special measures are taken to account for breathing movements.
Treatment times depend on the size and number of abnormal areas, but typically range from 15 minutes to an hour. If a single session of therapy is given, it is called stereotactic radiosurgery. If more than one session is required, the treatment is called stereotactic radiotherapy.
Three different machines are used to perform stereotactic radiosurgery:
Why the Procedure is Performed Return to top
Stereotactic radiosurgery can only treat well-defined tumors that are smaller than 3 - 4 centimeters. For some problems, stereotactic radiosurgery is the first choice. For other problems, it may be performed only when other procedures cannot be done.
Stereotactic radiosurgery was once limited to brain tumors, but today may be used to treat a variety of diseases and conditions, including:
Risks Return to top
Radiosurgery may damage tissue around the area. Brain swelling may occur in patients who received treatment to the brain. Swelling usually goes away, but some people may need medicine to control long-term swelling.
Outlook (Prognosis) Return to top
The effects of radiosurgery may take weeks or months to be seen. Your health care provider will monitor your progress using imaging tests such as MRI and CT scans.
Recovery Return to top
Recovery depends on many factors, including your overall health and the condition being treated. If you had a frame, the pins that held the frame in place will be removed. You may feel some discomfort where the pins used to be. Bandages may be placed over the pin sites.
Most people go back to their regular activities the next day, if there are no complications such as swelling. Some patients are kept in the hospital overnight for monitoring.
References Return to top
Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery, 17th ed. St. Louis, Mo: WB Saunders; 2004:2164-2166.
Goldman L, Ausiello D. Cecil Textbook of Medicine, 22nd ed. Philadelphia, Pa: WB Saunders; 2004:2353.
DeAngelis LM. Tumors of the Central Nervous System and Intracranial Hypertension and Hypotension. In: Goldman L, Ausiello D. Goldman: Cecil Medicine. 23rd ed. Philadelphia, PA: Saunders Elsevier;2007:chap 199.
Zivin JA. Hemorrhagic Cerbrovascular Disease. In: Goldman L, Ausiello D. Goldman: Cecil Medicine. 23rd ed. Philadelphia, PA: Saunders Elsevier;2007:chap 432.
Romanelli P, Anschel DJ. Radiosurgery for epilepsy. Lancet Neurol. 2006;5:613-620.
Kavanagh BD, Timmerman RD. Stereotactic radiosurgery and stereotactic body radiation therapy: an overview of technical considerations and clinical applications. Hematol Oncol Clin North Am. 2006;20:87-95.
Update Date: 4/10/2008 Updated by: Benjamin Taragin, MD, Department of Radiology, Montefiore Medical Center, Bronx, NY. Review Provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Page last updated: 25 September 2008 |