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Stereotactic Radiosurgery (SRS)


Stereotactic radiosurgery (SRS) is a radiation therapy procedure that uses specialized equipment to position you with such great accuracy that we can precisely and safely deliver large radiation doses to a brain tumor, while almost completely sparing nearby health brain tissue.


SRS involves the close cooperation of a team of medical experts including radiation oncologists, neurosurgeons, neurotologists, radiologists, medical physicians, dosimetrists, radiation therapists, oncology nurses, certified medical assistants, and others.  They are all dedicated to providing you with outstanding treatment and compassionate care.


Precision, Accuracy


SRS is not surgery in the conventional sense.  A finely-tuned radiation beam targets the tumor with a  precise dose of radiation that destroys the tumor cells.  No surgical incision is made, and only local anesthesia is used.  There is little risk of infection and no need to shave your head.  You should experience few, if any, side effects, and you can return home the same day as the procedure.


Unlike other forms of radiation therapy, SRS uses a large dose of radiation to destroy tumor cells in a single treatment session.  Custom designed narrow x-ray beams are focused from several different angles and deliver a high dose of radiation to a small, targeted area.  This approach offers extreme accuracy, down to the sub-millimeter level, and allows treatment in areas of the brain that may not be reachable with regular surgery.  In addition to treating some cancers, radiosurgery can also be used to treat malformations in the brain’s blood vessels and certain noncancerous (benign) neurologic conditions.

Sometimes a high dose of stereotactic radiotherapy can be focused upon a tumor outside the brain and given in a few treatments (typically three to eight). This form of treatment is called stereotactic body radiation therapy.



Treatment Planning


One to two weeks before the actual SRS treatment, you will be scheduled for a special MRI at Baystate Medical Center.  This MRI will be fused through computer software with a CT scan taken the day of the procedure at the Adamou Center for Cancer Care.  This allows the treatment team to accurately identify your tumor as well as the normal structures that are in the area.  By utilizing these precise imaging studies, your treatment team can target the radiation dose, contouring it around healthy structures near the tumor, and determine the appropriate radiation dose for you.  This precise planning session is a very important part of your treatment, and may take several hours to complete.


SRS Procedure


On the morning of your procedure, you will arrive and get settled.  Your positioning is a critical component of SRS so that imaging scans can accurately locate the tumor, which allows minimal radiation delivery to the normal tissues.  To make this possible, the treatment team will attach a rigid frame to your head, using small ceramic pins, to make sure there is no movement during treatment.


 ALT You will then undergo a CAT scan with the frame in place.  The new scan will be combined with your prior scans to provide the most accurate information possible to your doctors.  After your physicians have finalized the treatment plan and performed rigorous quality assurance testing, you will be brought into the treatment room.

Baystate uses a linear accelerator-based system that uses microwave technology to precisely focus high energy x-ray beams on a specific target to perform SRS procedures.  During your treatment, the linear accelerator will rotate around you.  Also, the table that you are on may be moved so that the target is hit from different angles.



For most people. the entire SRS process takes about a half day.  You should be able to leave approximately one hour after completion of your treatment, with no real restrictions on your activities.  You should have someone accompany you to provide transportation home, as you will not be allowed to drive a vehicle until the following day.

For certain types of tumors, Baystate also offers fractionated SRS, also called stereotactic radiotherapy (SRT), so-called because the tumor is treated over multiple sessions, or fractions, of radiation.  This is generally completed in two to five treatments over a period of one week.  If this is part of your treatment plan, you will be fitted with a removable flexible mask that can be reused for each treatment.

After Treatment

After your radiation therapy is complete, you will have follow-up appointments with your radiation oncologist, neurosurgeon or neurologist, to make sure your recovery is proceeding  normally and to check your health status.  You may also undergo some additional diagnostic tests.  Reports on your treatment may be sent to other specialists helping to treat your cancer.

The stereotactic radiosurgery team at the Baystate Regional Cancer Program is committed to offering the latest treatment technology to provide you with the best, most effective, and compassionate care.  For more information, please talk to your treatment team or call 413-794-9338.