Radiosurgery Techniques

Today's stereotactic radiosurgery procedures are based on hypofractionated techniques that use high doses of radiation on tightly defined tumors where the goal is to destroy target tumors or anatomical sites while sparing carefully defined adjacent critical structures and normal tissues.

The terminology to describe these techniques is often used interchangeably within the medical community, often only distinguished by context. Here are some standard definitions drawn from medical usage and literature today:

Stereotactic Radiosurgery (SRS)

SRS uses externally generated ionizing radiation to inactivate or eradicate a defined target(s) in the head or spine without the need to make an incision. The target is defined by high resolution stereotactic imaging, and treatment is typically performed in a single session, but can be performed in up to five sessions.

Stereotactic Body Radiation Therapy (SBRT)

SBRT involves the administration of a few very large radiation doses to an isolated tumor or tumors within the body, with the goal of complete tumor cell kill in the treated volume. Similar to SRS, SBRT is an image-based treatment, and a high dose of radiotherapy intended to eradicate the tumor could be given in one session.

Stereotactic Radiotherapy (SRT)

SRT is a type of external beam radiation therapy that can be completed in one to five days rather than several weeks. SRT is best for very small tumors as it can deliver the right amount of radiation in a shorter amount of time than traditional treatments. Doctors use specialized imaging equipment to pinpoint the exact location of the cancer cells, and monitor the area of the cancer and other organs on a screen while treatment is taking place. SRT is usually called stereotactic radiosurgery (SRS) when referring to treating tumors in or near the brain or spinal cord, and called stereotactic body radiation therapy (SBRT) when referring to areas of the body other than the brain or spinal cord.

Radiosurgery with the Novalis Tx™

Varian has helped pioneer new stereotactic treatment technologies that represent significant progress in the treatment of cancer and other conditions. Radiosurgery treatments take advantage of recent advances in imaging, precision beam delivery, treatment planning, and automated patient-positioning technologies. Delivering high radiation doses safely requires a high standard of precision in targeting the beam to the tumor shape and exact location.

The Novalis Tx™ radiosurgery platform has a tightly focused beam and can deliver doses more than 60 percent faster than conventional accelerators to reduce the effects of tumor motion, shorten treatment times, and enhance patient comfort. Guided by the most advanced set of imaging systems on any radiosurgery device, the Novalis Tx uses high definition shaped beam surgery, with the highest-definition multileaf collimator in the industry. This speeds treatment delivery with beams shaped to tumors from any angle.

In contrast, inefficient cone-based systems repeatedly paint tissue dose with non-conformal cylinders of radiation resulting in both hot spots and cold spots of dose to tissue. These are also constrained to anterior treatment. The precision of stereotactic radiotherapy promises exciting new options for patients, enabling radiation treatment in the earlier stages when cancer is most curable. This helps make many inoperable tumors treatable, and provides a noninvasive alternative to surgery.

With the Novalis Tx, doctors have a practical means of routinely treating tiny metastatic lesions where cancer has spread. New imaging processes, such as PET/CT scans in post-treatment checkups, help clinics detect these lesions and then eradicate them with image-guided stereotactic treatments.

 

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