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Stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) are modern techniques that use multiple, precisely focused beams of radiation to treat tumors in the brain, lungs, liver, spine, and other parts of the body.

They are not surgery in the traditional sense because they do not involve incisions. Instead, they use three-dimensional imaging to direct high doses of radiation to the tumor area with minimal effect on surrounding healthy tissue.

These are advanced radiation therapy techniques in which very high doses of radiation are delivered to small tumors with absolute precision. Stereotactic radiosurgery is used for tumors of the brain and central nervous system, while stereotactic body radiotherapy, which is its development, is used for tumors in the rest of the body.

What types of tumors do these advanced techniques treat?

The indications for these two techniques are very many. Stereotactic radiosurgery concerns malignant tumors of the brain and the rest of the central nervous system, both primary and secondary, that is, tumor metastases from other parts of the body. In the case of brain metastases, this technique is replacing the old, classic, whole-cranial radiotherapy, gaining ground, as it greatly reduces side effects.

Our patients are no longer at risk of memory loss, effects on their higher mental functions, or alopecia, which also has a positive effect on the psychology of our patients! Stereotactic radiosurgery is also indicated for certain benign tumors, such as acoustic neuroma, meningioma, pituitary adenoma, and certain other brain diseases such as arteriovenous malformations and trigeminal neuralgia. It can be administered either alone or as a complement to surgical removal of the tumor.

As for stereotactic body radiotherapy, it is applied to primary or secondary tumors of the lung, pancreas, liver, adrenal glands, bone metastases in bones of the spine, in early stages of prostate cancer, etc.

What are the effects of stereotactic radiosurgery?

Its results are often comparable to surgical removal of the tumor, which it can replace in certain cases, such as when the patient is not in good general health and is unable to undergo surgery, when the tumor is not accessible to the surgeon, or when we have multiple tumors and it is not possible for the patient to undergo corresponding multiple surgeries.

What are the advantages of these advanced techniques?

Their greatest advantage has to do with the fact that they are very focused techniques, with millimeter accuracy. In fact, when we talk about the brain and the central nervous system, the accuracy can be less than a millimeter. Also, a very high therapeutic dose is administered, meaning it has an increased ability to destroy cancerous tumors, without affecting the surrounding healthy tissues. As a result, we have fewer side effects and a better quality of life for our patients, which is – along with the optimal oncological outcome – the goal of all medical practices.

It is also important that the treatments are carried out in a small number (1 to 5) sessions. In this way, the treatment is completed in one to two weeks and thus does not interfere with the normal life of the patients. At the same time, time is saved for the rapid initiation of other treatments that the oncological patient may need, such as chemotherapy and immunotherapy. These techniques are non-invasive, bloodless and painless, without the need for anesthesia and without causing discomfort and stress to the patient.

Here, however, it should be noted that stereotactic radiosurgery and stereotactic body radiotherapy came not to replace classical radiotherapy, but to give us an additional weapon in the treatment of small tumors.

How is stereotactic radiosurgery performed?

It is a short procedure that lasts from 15 to 30 minutes. The patient enters the room, lies down on the machine bed and his personal immobilization mask is placed. There is no longer a need to use the special interventional frames that were used in the past. Just before each session, a CT scan is performed at the treatment site. At the same time, there are systems that, both before and during the treatment, check the patient’s surface in real time and detect any movement. This ensures the absolute accuracy of this focal technique.

The treatment process is very simple and short. The machine but revolves around the patient, without anything touching him and this is another factor that contributes to the patient’s calmness throughout the session.

What does a patient need to know about the type of treatment he will choose?

A patient should first contact a specialized Radiation Oncologist who will have the knowledge and experience to design, in collaboration with other medical specialties, depending on the case, the appropriate and personalized treatment plan.

On the other hand, it is important to choose treatment centers that have the technological equipment, strict quality assurance protocols and the infrastructure that will allow them to support the most modern treatment techniques. All staff (Radiation Oncologists, Radiation Physicists, Radiation Therapy Technologists, Nurses) must be specially trained for these techniques. One such center, the only one in Northern Greece, is the Interbalkan Medical Center of Thessaloniki, where we have the most modern equipment to apply the most advanced stereotactic radiosurgery and stereotactic body radiotherapy techniques, with impressive results.

It should be emphasized that in the context of the opening of the new International Oncology Center, the first, in Northern Greece, ultramodern EDGE radiosurgery system of the Varian company was installed and is operating, in the Department of Radiation Oncology and Stereotactic Radiosurgery of the Interbalkan Medical Center of Thessaloniki, offering new possibilities and options in the treatment of oncological patients.