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Stereotactic Radiation

Type of radiation therapy, in which radiation of tumors is performed in high doses for 1–5 sessions.


  1. What is stereotactic radiation?
  2. Methods used
  3. Advantages of this treatment option
  4. Indications and contraindications
  5. How is treatment carried out?
  6. Advantages in choosing “Saknur”

What is stereotactic radiation?

Stereotactic radiation is a type of radiation therapy in which radiation of tumors is performed in high doses for 1–5 sessions. In case of a high-dose radiation in a single session, the procedure is called radiosurgery, and in case of radiation therapy dose delivery in 3–5 sessions, the procedure is called stereotactic radiation therapy. The tactics of treatment are determined by the size and location of the tumor.

Stereotactic radiosurgery is not a surgical procedure in the traditional sense, since it is not invasive. It is based on high-precision delivery of a high dose of radiation directly into the tumor, bypassing healthy surrounding tissues. This is the fundamental difference of this technology.

Methods used

To carry out stereotactic operations, three main methods are used, the differences of which are primarily in the used radiosurgery equipment:

  • Gamma knife. In this case, the neoplasm is irradiated with a beam of clearly focused gamma rays. The method is optimal for small and medium-sized intracranial lesions.
  • Linear accelerators. Such equipment for fractionated stereotactic radiosurgery delivers high-energy X-rays (photon beams) directly to tumor nidus. The method is also applicable in the treatment of extensive neoplasms.
  • Proton therapy. This is a method of radiosurgery with heavy particles.

To determine the localization, shape and size of the tumor, three-dimensional visualization technologies are used: computer, magnetic resonance or positron emission tomography.

Advantages of this treatment option

Thanks to stereotactic radiosurgery, modern medicine has been able to reach the smallest tumors with a deep bedding in the brain tissues. Earlier neoplasms with such localization were considered inoperable.

In contrast to traditional radiotherapy, stereotactic radiation can be repeated, so this technology is also in demand when recurrences occur after standard radiotherapy.

Other benefits of technology:

  • Noninvasivity,
  • No need for long-term preoperative training and post-operative rehabilitation,
  • Possibility of ambulant therapy of serious brain tumors,
  • No anesthesia and surgical complications.

Indications and Contraindications

Initially, the method of stereotactic radiation therapy was developed for the treatment of the brain neoplasms, including arteriovenous malformations (AVM), in order to avoid craniotomy. However, it is now also used in liver cancer, lung cancer and multiple metastases.

In brain tumors, radiosurgical irradiation is indicated in the following cases:

  • Benign and malignant neoplasms,
  • Primary and metastatic lesions,
  • Single and multiple neoplasms,
  • Residual tumor nidi after surgical intervention,
  • Intracranial lesions of the skull and eyesocket bases,
  • Arteriovenous malformations (AVM).

The procedure is not indicated if the tumor size exceeds the acceptable size (3–5 cm). This is due to the fact that at a high radiation dose of the nidus, the dose exposure to surrounding tissues and organs also increases.

How is treatment carried out?

Treatment begins after pre-dosimetric planning. The procedure can take from 10 minutes to 1 hour ― depending on the complexity of the clinical case and the equipment used. Stereotactic radiosurgery is usually performed once, but sometimes several sessions are required, for example, in large tumors.

For the treatment, high spatial accuracy of patient placement and careful fixation during treatment is required. Initially, the method was developed to treat brain tumors, so the so-called “hard” fixation of the patient’s head was used during the procedure ― when a special fixing frame is implanted in the patient’s skull. It is used to treat brain tumors with a gamma knife.

Fixation is extremely important for stereotactic irradiation, since in this case the risk of exposure to vital organs located near the irradiated object is high.

The TomoTherapyTomoHD system uses the sparing fixation of the patient. For example, to exclude the escalation of a tumor of lung cancer, a specialized stand with restriction of chest movement during breathing, and for fixing the head ― a stereotactic frame with a special individual dental fixator are used, i.e. no blood and pain during the session.

Thanks to stereotactic radiation therapy, modern oncologists-radiologists can achieve the maximum damaging effect to the tumor, minimizing the effect of radiation on healthy tissues. This reduces the risk of side effects.

Advantages in choosing “Saknur”

In the Volga Center of Tomotherapy “Saknur” you can get advice from a neurosurgeon and a radiotherapist to determine the possibility of stereotactic and radiosurgical treatment with the TomoTherapyHD tomotherapy unit.

The Center of Tomotherapy “Saknur” employs highly qualified specialists with more than 10 years of experience, who select the optimal therapy program for each patient and do their best to ensure that the treatment is as effective and safe as possible.

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