The Stereotactic Radiotherapy team at Brigham and Women’s Hospital offers a multidisciplinary and innovative stereotactic approach to treating benign and malignant tumors, vascular disorders, as well as other disorders affecting the nervous system such as Parkinson’s disease. A team of neurosurgeons, radiation oncologists, physicists, and nursing staff work together to provide each patient with the most appropriate, effective and safe treatment available. The majority of patients return home at the end of the day’s treatment and are able to return to their usual daily schedule on the following day.
Stereotactic Radiosurgery (SRS) is a procedure that uses radiation and computer targeting to direct focused radiation to specific targets in the brain thus minimizing injury to surrounding structures. There are different approaches used in stereotactic radiosurgery. At Brigham and Women’s Hospital the procedure is performed under local sedation with patients fitted with a face mask to guide targeting. Neither a head frame nor a surgical incision is needed. An important benefit of stereotactic radiosurgery is its ability to treat tumors in locations that are difficult to reach with conventional neurosurgical techniques. The procedure also is valuable in treating persons who are not candidates for open neurosurgery due to age, medical condition or personal preference.
In some instances (such as for larger tumors), the radiation treatment is divided, or fractionated, over several days. In this instance the treatment is called stereotactic radiotherapy, or SRT.
Benign and Malignant Tumors: Stereotactic radiotherapy is most frequently used to treat benign and malignant tumors of the brain, skull-base as well as the head and neck and may be used alone or in combination with other treatment modalities such as surgery or chemotherapy. The tumors treated may have originated in another part of the body such as the breast or lung and spread (metastasized) to the brain or they may have originated in the brain (including meningiomas, pituitary adenomas, acoustic neuromas, and craniopharyngiomas). In some instances, radiosurgery may be used to treat primary malignant tumors including glioma or oligodendroglioma.
Vascular Neurosurgery: Stereotactic radiotherapy is an important tool for treating vascular lesions such as arterio-venous malformations (AVMs) either as a stand-alone treatment or in concert with additional treatments such as vascular embolization.
Functional Neurosurgery: This is an exciting and ever-expanding area of stereotactic radiosurgery and includes treatment of trigeminal neuralgia and other pain syndromes. Now, SRS is being used in the treatment of some forms of epilepsy including those associated with hypothalamic hamartomas. Stereotactic radiotherapy also may be used to treat the symptoms (primarily tremor) associated with a number of movement disorders including Parkinson’s Disease, dystonia and essential tremor. Research is ongoing with respect to the use of stereotactic radiosurgery in the treatment of a number of psychiatric disorders such as obsessive-compulsive disorder and mania.
Brian Alexander, MD, MPH
Department of Neurosurgery
Brigham and Women's Hospital
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