Stereotactic Radiosurgery (SRS)

Stereotactic Radiosurgery (known as “SRS”) is a type of high-dose, very focused radiation sometimes recommended to treat cancer within the brain. This is a special procedure with different brand names (TrueBeam, CyberKnife, GammaKnife, etc.) not offered at all radiation clinics, but has been commonly done at ours for several years.

Typically, SRS takes 30-45 minutes per treatment in the office. It is given in 1-5 treatments

daily or every other day, depending on the side effects your doctor is trying to minimize.

To start your treatment, we will arrange for the following appointments:

• Treatment planning session or “simulation”

• Treatment

We aim to start your treatment within 1-2 weeks after the treatment planning session, and will provide you with a time for the dry run after this appointment.

Treatment Planning Session (“Simulation”)

Radiation therapy must be aimed precisely at the tumor each time treatment is given. The

process of measuring your body and tumor to help your team direct the beams of radiation

safely and accurately to their intended locations is called simulation.

During this appointment, your radiation oncologist and radiation therapist place you on the CT

scanner table in the office in the exact position you will be in for treatment. Immobilization

devices such as custom masks, headrests, or other devices are frequently used to help you remain

in the same position during the entire treatment. You can see and breathe through the mask, and an opening is often near the eyes, nose, and mouth.

If you are very claustrophobic, let your doctor know beforehand. They can sometimes provide medication to take an hour before your appointments.

The patient is ready for SRS treatment

Under the radiation oncologist’s supervision, the radiation therapist marks the area to be treated on the immobilization devices and/or your skin with either a bright, temporary paint or

a set of small, permanent tattoos. This CT scan helps design the radiation beams' placement and shape. We will also use any MRI scans you have done at any other facility to plan your radiation.

After this appointment, our work begins! We are planning your radiation with other members

of our team (dosimetrist and physicist) to customize your radiation and ensure it minimizes

any side effects. This process can take several business days. If you have a question about

where your treatment plan is, you can call our office for an update.

Treatment

On the day of your treatment, arrive 15 minutes before your appointment. Follow any

instructions that your doctor provided to you to prepare. Treatment will last 20-30

minutes in the office, although much of this time involves setting you up and ensuring you

are positioned the same as before.

After each treatment, we will have you meet with the nurse to review any side

effects. Your doctor will meet with you on a weekly basis or sooner if medically necessary. If you are on steroids (dexamethasone or Decadron), check with your doctor for

instructions on how to take this medication during and after treatment.

If you notice worsening of any neurologic symptoms or any of the following, notify your doctor or the nurses immediately:

• Persistent headaches

• Worsening nausea

• Profound fatigue

• Confusion

• Seizures

• Weakness or numbness of arms/legs

On your last day of treatment, you can set up a follow-up appointment with your doctor to check on any side effects and finalize a plan for any tests. If you have any symptoms or concerns before this appointment, please do not hesitate to call our office.

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