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Stereotactic Body Radiation Therapy

Stereotactic Body Radiation Therapy (SBRT) is a type of radiation treatment like SRS, except that it treats tumors outside of the brain. SBRT requires a number of special techniques to deliver ablative RT safely and effectively. This includes custom and strict immobilization, use of multiple beams to create conformal dose distribution, image guidance with each treatment with cone-beam CT, and accuracy within millimeters. Multiple beams allows for shaping of highly conformal dose, particularly sparing the critical structures which can be within millimeters of the target volume. SBRT is always delivered in either a single high-dose treatment or up to 5 treatments, depending on the type of cancer being treated, the tolerance of adjacent normal tissues, and other factors.

GW’s Radiation Oncology department offers the most advanced treatments to patients whose cancers range from the relatively common to the most complex and rare, in a caring, patient-focused environment. GW is at the forefront of technology with the state-of-the-art TrueBeam™ STx system.

The TrueBeam™ STx is an advanced, top of the line linear accelerator designed to treat well-defined tumors at any site in the body. Its micro-MultiLeaf Collimator (MLC) allows for stereotactic treatment of small tumors. We use the TrueBeam™ STx to treat malignancies located in the brain, spine, head and neck, lung, liver, and pancreas, both in conventional dose fractionation and radiosurgery.

GW Radiation Oncology developed a more focused approach for treating prostate cancer using a form of radiosurgery called stereotactic hypofractionated accelerated radiation to the prostate (SHARP). SHARP can deliver ultrahigh doses of radiation in only five treatment sessions, compared with close to 45 sessions over-nine weeks using conventional IMRT. In addition, we are pioneering the use of live-tracking of lung cancers during radiotherapy using implantable positioning devices. This technology allows a more precise target area to be treated in early-stage lung cancer. Finally, we designed a stereotactic body radiotherapy protocol using higher doses of radiation to treat pancreatic cancer in five or fewer sessions — compared with more than five weeks for conventional radiation treatment.

Prostate SBRT

Prostate cancer can be a life-changing diagnosis for men and their families. Because each patient's condition is different, it is very important to gather all of the information about your condition and the treatment options that are available to you before making a decision.

GW Radiation Oncology developed a more focused approach for treating prostate cancer using a form of Stereotactic Body Radiation Therapy (SBRT) called stereotactic hypofractionated accelerated radiation to the prostate (SHARP). SHARP can deliver ultrahigh doses of radiation in only five treatment sessions, compared with close to 45 sessions over 9-10 weeks using the conventional approach. SHARP treatment involves no cutting, no pain, and no hospital stay. It is a safe alternative to surgery for the treatment of cancerous and non-cancerous tumors anywhere in the body - including the prostate.

You and your doctor will evaluate various treatment options and their advantages and disadvantages to determine the best treatment plan for you.

Type of Procedure

  • Prostate SBRT: No incision - delivers radiation from outside the body to treat cancer inside the body
  • Radical Prostatectomy Surgery: Surgery (may not be appropriate for patients of advanced age or those with multiple medical conditions); may be traditional surgery or less invasive surgery using da Vinci Surgical System


Treatment Settings

  • Prostate SBRT: Outpatient treatment, no hospital stay or anesthesia
  • Radical Prostatectomy Surgery: Hospital stay and general anesthesia


Accuracy/Damage to Surrounding Tissue

  • Prostate SBRT: Sub-millimeter accuracy that protects surrounding structures and tissues
  • Radical Prostatectomy Surgery: Removes the entire prostate while trying to spare muscles and nerves that control urination and sexual function


Recovery/Side Effects

  • Prostate SBRT: No recovery time; patient quickly resumes normal activities
  • Radical Prostatectomy Surgery: Pain associated with surgery; post-operative recovery time; erectile dysfunction; radiation therapy may be required after surgery


Outcomes

  • Prostate SBRT: Research shows excellent PSA responses and low rates of recurrence. Longer follow-up is needed to confirm these findings.
  • Radical Prostatectomy Surgery: High cure/survival rates in favorable-risk patients

Radical Prostatectomy

A radical prostatectomy is a surgical treatment for cancer that has not spread beyond the prostate. The patient may be under general or spinal anesthesia. The surgeon removes the prostate and possibly the lymph nodes while trying to spare the nerves that would affect erectile functions. Because the surgeon must cut the urethra, which runs through the center of the prostate gland, and reattach it after removing the prostate, the patient will have a catheter for several days. The patient typically will remain in the hospital for 2-4 days and will have a recovery time of about 12 weeks.

A radical prostatectomy often cures prostate cancer. After the procedure, a few men (less than 3%) are incontinent of urine, while about 50% lose erectile function.

Lung SBRT

GW Radiation Oncology developed a more focused approach for treating lung cancer that uses high doses of radiation delivered to a precise target called stereotactic body radiotherapy (SBRT). By using special positioning and implanted markers in the body, radiologists are able to deliver a much higher dose of radiation to a cancer than IMRT or 3DCRT, while sparing healthy tissue. SBRT involves no cutting, no pain, and no hospital stay. It is a safe alternative to surgery for the treatment of cancerous and non-cancerous tumors anywhere in the body - including the lung.

Uses for People with Lung Cancer

At this time, there are three primary reasons why SBRT may be used with lung cancer:

  • For early stage, small lung cancers (non-small cell lung cancer) in patients who are unable to have surgery for some reason. A lung cancer could be considered inoperable due to the location of the tumor, or other health conditions exist which could make lung cancer surgery risky.
  • For elderly patients who may be expected to do poorly with surgery or have medical conditions which may raise the risk of surgery complications.
  • For one or a few areas of spread of the lung cancer or metastasis (oligometastasis).

Procedure

SBRT uses a high dose of radiation delivered to a very precise region of tissue. This is in contrast to conventional radiation therapy for lung cancer which uses a much smaller dose of radiation given over time. Radiologists map out coordinates in four dimensions to accurately define the area to be treated.

SBRT for Primary Lung Cancer

SBRT can sometimes work as effectively as surgery for some people with primary lung cancers which are otherwise inoperable, or in patients who have medical conditions which could make surgery dangerous. SBRT has resulted in control of the disease comparable to surgery, and long-term survival has been possible in people carefully chosen for the procedure. Tumors need to be small, usually less than 5 cm (2-3 inches) in diameter, and not be too close to the airways or the heart.

You and your doctor will evaluate various treatment options and their advantages and disadvantages to determine the best treatment plan for you.

Contact Us

Contact GW Radiation Oncology:
Main Phone: (202) 715-5097
Fax: (202) 715-5136

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