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Stereotactic Body Radiosurgery(SBRS) is a treatment technique that uses special equipment to position a patient and precisely deliver external radiation therapy to tumors in the body (except the brain). When using SBRS, very high doses of radiation are delivered in one to five treatments.
SBRS is used to treat isolated tumors in the lung, liver and spinal column. The advantage of this type of radiation therapy is that it helps spare healthy tissue while focusing radiation dose on the tumor. In many cases, the control of cancer is as good as, or better than surgery. Because of the small area treated and the precision in delivery, there are very few side effects with this type treatment.
Areas in the lung, where the tumor moves due to breathing, can be difficult since the tumor becomes a moving target. Due to the high precision needed in SBRS, a technology called Gating is used to compensate for this motion to allow precise targeting of the radiation.
Types of cancers treated with SBRS:
Lung Cancer - 95 percent of lung cancers are controlled with SBRS.Patients who may be considered for SBRS treatment:
· Primary lung cancer (tumors that begin in the lung)
o Patients with early stage lung cancer (tumors up to 5 cm)
o Patients who cannot tolerate surgery
o Patient who do not want surgery
· Secondary (metastatic) lung cancer (cancer that has spread to the lung from elsewhere in the body)
o Patients who have up to three lung nodules (or more in certain circumstances)
Liver Cancer — 92 percent to 100 percent of tumors are controlled with SBRS
Patients who may be considered for SBRS treatment:
· Primary liver cancer (tumors that begin in the liver)
Secondary (metastatic) liver cancer (cancer that has spread to the liver from elsewhere in the body)
o Patients with up to three liver tumors (or more in certain circumstances)
o Patients with tumors less than 6 cm
o Patients with limited active disease (metastatic cancer) elsewhere in the body
Cancer of the Spine — 85 percent to 90 percent symptom response rate for paraspinal tumors (tumors adjacent to the spinal column)
The use of SBRS for spinal tumors is palliative. Patients who may be considered for SBRS treatment:
· Primary tumors
o Patients with primary tumors that cannot be removed with surgery
o Patients with metastatic tumors (tumors spread from other cancers) when there is limited spread elsewhere and surgery is not a good option
o Patients who require retreatment of tumors that have grown after previous radiation therapy
· Metastatic Cancer — SBRS is indicated for select patients with metastatic cancer in discrete, treatable locations that will result in complete clearance of tumors and decrease the overall burden of cancer.
SEE ALSO: SBRT
Advanced Technology for SBRT
Oakwood Cancer Center has offered Stereotactic Body Radiation Therapy (SBRT) since 2006. Advanced technologies which are highly customized for each patient’s treatment planning are used These technologies include:
· 3D (three-dimension) CT-based treatment planning — a technique that provides information to help plan when breathing impacts tumor motion. This allows us to conform the radiation dose to the tumor’s motion. By accounting for tumor motion during treatment, doses to critical organs can be limited while delivering higher doses to the tumor.
· IMRT— a treatment designed to deliver intensity modulated radiation therapy (IMRT). IMRT can treat small or large tumors in one region of the body or several regions, using a variety of doses. Oakwood will do a CT scan before each treatment to ensure the patient is perfectly aligned. A thin beam rotates around the patient from many directions. This results in hundreds of beams of different intensities converging on the tumor(s). A computer calculates the treatment plan and coordinates treatment delivery.
· Body Frame — an immobilization device used to help the patient be still during the treatment and allowing for the high positional precision needed for SBRT
.· Respiratory gating — in areas of the body, such as the lungs and abdomen, where tumors can move as the patient breathes, respiratory gating is used. This technology determines the patient’s breathing cycle and allows the precise position of the tumor to be known. This allows for the high precision SBRT treatment for theses areas.