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Stereotactic Radiosurgery (SRS)

We offer state-of-the-art stereotactic radiosurgery to our cancer patients. Despite the name, SRS is not a surgical procedure. SRS is a commonly used technique for treating brain tumors and vascular malformations (abnormal blood vessels that are prone to bleeding without treatment).

SRS treatments are available at Brigham and Women's Hospital's main campus, at Dana-Farber/Brigham and Women’s Cancer Center in clinical affiliation with South Shore Hospital and at Brigham and Women's/Study Memorial Radiation Oncology Center.

What is Stereotactic radiosurgery (SRS)?

  • A noninvasive procedure
  • SRS delivers high dose radiation precisely to a specific target in the brain
  • Commonly used technique for treating benign and malignant brain tumors, as well as vascular malformations.
  • The tumor receives a high dose of radiation, but the surrounding brain receives a minimal amount of radiation.

What are a few advantages of Stereotactic Radiosurgery (SRS)?

  • Many patients can be treated in a single radiation session.
  • Recovery periods are often short with minimal side effects.
  • The risk of serious long-term side effects with SRS is low.
  • SRS has revolutionized the way we treat many patients with brain tumors, and in certain scenarios it can improve patient survival.

What is it like to receive Stereotactic Radiosurgery (SRS)?

Before treatment, you will receive CT and MRI scans, and special stereoscopic x-rays, to help create a highly precise radiation plan for you.

During treatment, you will be given a customized external mask molded to the contours of your face and head. This mask helps to prevent movement as SRS requires immobilization. Because the brain does not move (as do the lungs, for example) and the skull serves as a stable gauge for the location of the tumor, the clinical team can deliver high doses of tightly focused radiation beams with pinpoint precision to treat tiny tumors.

Can Stereotactic Radiosurgery (SRS) be used on large tumors?

Large tumors sometimes require radiation to be given over multiple treatment days, a technique called stereotactic radiotherapy (SRT).

Innovative Applications

What are some innovative applications of Stereotactic Radiosurgery at Brigham and Women’s Hospital?

A significant percentage of patients we treat with SRS have brain metastases (which is when the cancer spreads from other parts of the body to the brain). In patients with 1-4 brain metastases, SRS is generally favored over whole brain radiation, a technique that treats the entirety of the brain, as it causes less side effects. In patients with more than 4 brain metastases, whole brain radiation is considered more standard treatment. Our radiation oncologists have designed a clinical trial to test the effectiveness of whole brain radiation against SRS in patients with 5-20 brain metastases. If successful, this may be the first trial to assess whether patients with 5-20 brain metastases can be safely treated with SRS.

Our radiation oncologists and physicists have also developed a technique called one-isocenter, multi-target volumetric modulated arc therapy to treat many tumors in the brain in one session. Historically, if a patient had multiple tumors in the brain, radiation had to be delivered to each tumor in sequence, causing treatment to last many hours. Using this new technique, multiple tumors can be treated in approximately 30 minutes.

We have also implemented a patient-tracking system called optical surface monitoring system (OSMS), which monitors patient motion in real-time. If the patient were to somehow move, the treatment stops until the patient is still. This new system helps increase the precision of the treatment.

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