Stereotactic Radiotherapy (SRS)

Medically reviewed by Dr. Prabhu and Dr. McCall on 12/21/23

Stereotactic radiosurgery (SRS) represents a specialized approach for treating smaller tumors in the skull, employing highly targeted, high-dose radiation therapy that is delivered with sub-millimeter accuracy. Typically administered in 1-5 treatments, these methods fall under the umbrella of stereotactic ablative radiotherapy (SABR), utilizing precisely delivered radiation beams to address specific areas.

Due to its precision, stereotactic techniques offer the advantage of sparing surrounding normal tissues more effectively compared to conventional external beam therapy. Moreover, stereotactic radiotherapy involves a smaller number of total treatments than traditional radiation therapies.

The physicians at SERO were among the early adopters of this advanced technology, establishing expertise in the science and application of SABR. As you contemplate your next steps in cancer treatment, your SERO cancer doctors in Charlotte are available to address any inquiries you may have about these techniques.

This page is designed to provide you with insights and guidance on understanding Stereotactic Radiotherapy as a treatment option.

What is Stereotactic Radiotherapy?

Stereotactic Radiotherapy (SRT) stands as an advanced therapeutic radiation approach. When applied to the brain, it is called stereotactic radiosurgery (SRS), and when used with multiple fractions in the brain/spine or up to five treatments in various parts of the body, it is referred to as Stereotactic Body Radiotherapy (SBRT).

This innovative technique employs highly focused external beam radiation to target smaller tumors, aiming for effective tumor control or elimination.

Originally conceived as an alternative to invasive brain surgery, stereotactic radiosurgery eliminates the need for incisions or surgical procedures. Instead, it delivers precise radiation beams through the skin to reduce or eliminate cancerous cells.

Stereotactic radiosurgery has become a preferred treatment for several types of brain tumors due to its non-invasive nature and effectiveness.

Many oncologists advocate for stereotactic radiotherapy because its precise targeting minimizes the impact on surrounding tissues, thereby lowering the risk of both acute and long-term side effects.

Ultimately, stereotactic radiosurgery is particularly well-suited for tumors that are challenging to access through other treatment methods, particularly those located in the spine or brain.

How does Stereotactic Radiotherapy Work?

Stereotactic Radiotherapy involves multiple precise radiation beams that intersect to target tumors. Similar to other radiation treatments, these beams induce damage to the DNA of cancer cells, leading to their demise and subsequent tumor shrinkage.

Despite being occasionally termed stereotactic radiosurgery, it is not an actual surgical procedure, involving no incisions. Stereotactic Radiotherapy utilizes 3D imaging, such as CT or MRI scans, to map the tumor. Subsequently, radiation beams are directed through the skin to reach the tumor.

The machines delivering Stereotactic Radiotherapy utilize numerous high-energy beams, with each individual beam having a minor impact on the tumor. Collectively, however, they can effectively destroy cancerous tumors.

Radiation oncologists employ two main technologies to administer these radiation beams:


Linear Accelerator (LINAC)

These machines use X-rays or photons to damage cancer cells. Linear accelerators are often employed for stereotactic radiosurgery on the brain, typically requiring a single session. In the case of larger tumors, three to five sessions may be necessary. Linear accelerators are sometimes referred to by their brand names, such as TrueBeam or CyberKnife.


Gamma Knife

Gamma Knife machines are specifically designed for Stereotactic Radiotherapy, using gamma rays to treat cancer. They utilize 192 precise radiation beams to target tumors in the brain.

Cancers Treated by Stereotactic Radiotherapy

Stereotactic radiosurgery is employed in the treatment of cancers primarily located in the brain. It is often the favored approach for addressing small tumors, particularly those situated in hard-to-access regions. The method proves advantageous for tumors located near vital organs or sensitive anatomical areas due to its precision, which typically minimizes radiation dose exposure in surrounding tissues.

Stereotactic radiosurgery is utilized in the treatment of various types of brain tumors, including:

  • Benign tumors
  • Malignant tumors
  • Primary tumors
  • Metastatic tumors
  • Intracranial tumors
  • Orbital tumors
  • Base-of-skull tumors
  • Residual tumor cells following surgery

The versatility of stereotactic radiosurgery extends to its applicability in addressing a diverse range of brain tumors, making it a valuable option across different tumor types and conditions.

What to Expect During Stereotactic Radiosurgery

Stereotactic radiosurgery (SRS) is typically conducted as an outpatient procedure in a single fraction with the entire process taking usually less than 1-2 hours though patients with multiple lesions may take longer. It is advisable for patients to have a friend or family member accompany them to provide transportation and support.

Before Stereotactic Radiosurgery

In preparation for the procedure, your cancer care team will dedicate time to plan your treatment, ensuring precise and accurate delivery of radiation. This planning usually occurs one or several days before the actual treatment.


Step One: Prepare the Mask

A custom mask is made for each patient. This mask stabilizes your head and ensures precise treatment.


Step Two: Imaging Scans

After the face mask fitting, imaging scans, such as CT or MRI scans, are conducted in order to accurately map the tumor.


Step Three: Plan Your Dosage

Utilizing information from the imaging scans, the team will design the radiation plan to deliver the intended radiation dose to the tumor while maximally sparing surrounding normal tissue.

During Stereotactic Radiosurgery

You won’t feel the radiation entering your body. While a mild sedative may be administered to help you relax, you remain awake throughout the procedure and can communicate with your doctor.

How to Prepare for Stereotactic Radiosurgery

Before your procedure, you should follow the instructions of your cancer care team, which may vary depending on your cancer. However, most radiation oncologists will ask the following:

  • Wear comfortable clothing during your procedure. Do not wear jewelry, makeup or nail polish, glasses or contacts, dentures, or wigs.
  • Communicate with your doctor regarding any medications you’re taking before your procedure. He or she will recommend whether or not to take the medications leading up to your treatment

Side Effects of Stereotactic Radiosurgery

One of the primary benefits of Stereotactic Radiosurgery (SRS) is its precision, minimizing impact on surrounding tissues and possible radiation-related symptoms. However, some patients may experience short-term side effects in the days to weeks following treatment, including:

  • Fatigue
  • Headache
  • Nausea
  • Vomiting
  • Scalp irritation or sensitivity
  • Hair loss

While these short-term effects are possible, it’s important to note that they are typically temporary. On rare occasions, patients may encounter other long-term side effects, which may manifest months or even years after treatment and, in some cases, become permanent. These long-term effects may include brain or neurological problems. It is crucial for patients to communicate openly with their healthcare team about any side effects experienced during or after treatment, as this allows for timely intervention and support.

Choosing SERO for Stereotactic Radiosurgery

Opting for Stereotactic Radiosurgery (SRS) is a decision that demands specialized expertise, and SERO stands out as one of the most experienced groups in the country, providing access to this cutting-edge technology.

The SERO group extends its specialized SRS treatment across several centers, including several Levine Cancer Institute locations, Novant Presbyterian Hospital, Caromont Regional Medical Center, Rock Hill Radiation Therapy Center, and Frye Regional Medical Center.

Distinguished by being early adopters of this advanced technology, our group of physicians possesses unique expertise and extensive experience in the field. Many of our physicians have undergone highly specific training in radiosurgery and radiotherapy, ensuring the highest standard of care.

Beyond our accomplished team of radiation oncologists, SERO offers a supportive and educational environment for all cancer patients. Whether you seek information about SRS or are considering a second opinion regarding your treatment options, we are committed to providing assistance and guidance throughout your journey.

FAQs About Stereotactic Radiosurgery

What are the side effects of stereotactic radiosurgery?

Stereotactic radiosurgery is highly precise, resulting in fewer side effects compared to other radiation treatments. However, patients may experience short-term effects in the days to weeks following treatment, including fatigue, headache, nausea, vomiting, scalp irritation or sensitivity, or hair loss.

Is stereotactic radiosurgery painful?

No, stereotactic radiosurgery is not painful. Patients do not feel the radiation during the procedure.

How long is recovery after radiosurgery?

SRS is an outpatient procedure. Some individuals may choose to take 1-2 days off from work following treatment to manage potential side effects such as nausea, headache, or fatigue.

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