Radiosurgery is a procedure involving the delivery of a high dose of precisely aimed radiation beams. Although it is called surgery, no incision is made. Radiosurgery involves a single treatment, while radiotherapy involves the delivery of precisely aimed radiation over multiple treatments.
The UC Neuroscience Institute was the first in the world to offer LEXAR, an integrated system for stereotactic radiosurgery, stereotactic radiotherapy and intensity-modulated radiotherapy.
The Precision Radiotherapy Center in West Chester, Ohio, opened in September 2003 to provide another option for patients with tumors or other neurological disorders. Developed by the Mayfield Clinic and University Radiology Associates, two nationally recognized neuroscience programs affiliated with the University of Cincinnati College of Medicine, Precision Radiotherapy was the region’s first center to offer high-precision radiotherapy/radiosurgery for tumors and other abnormalities both inside and outside the brain.
By attacking the tumor with multiple treatments of lower-dose therapy, sterotactic radiotherapy enhances the biological effect on the tumor while reducing the amount of radiation to nearby critical structures, such as the brain stem, eyes or optic nerves. This benefit can be particularly important in the treatment of children, whose brains are still developing.
Three-dimensional (3-D) conformal radiotherapy
Radiation oncologists at The Neuroscience Institute have participated in developing three-dimensional conformal radiotherapy, an advanced technology for delivering radiation. With this therapy, radiation beams are manipulated by the computer to precisely conform to the shape of the tumor.
3-D conformal radiation treatments significantly spare normal brain tissue and allow much higher doses to be delivered to the brain tumor. For patients with tumors that are usually successfully treated with radiation (e.g., pituitary tumors, meningiomas, craniopharyngiomas) three-dimensional conformal radiation should result in fewer early and late side effects. For patients with tumors that are often only partially responsive to radiation (e.g., metastatic tumors, glioblastoma) 3-D conformal radiotherapy provides the ability to increase the tumor treatment dose without the risk of increased side effects.
Neuroscientists believe that 3-D conformal radiotherapy has the potential to significantly improve the outcome of patients who require radiotherapy.
Intensity modulated radiotherapy
As an extension of 3-D conformal radiotherapy, intensity modulated radiotherapy, in some situations, can provide superior conformation of the radiation field when compared to stereotactic or 3-D conformal techniques.
Noninvasive plastic mask
Patients with tumors inside the head benefit from one of the most important developments in recent years: the replacement of the invasive head frame previously used for brain radiosurgery with a non-invasive plastic mask. In 2009 John Breneman, MD, and his colleagues at the Precision Radiotherapy Center and UC Brain Tumor Center published their research findings that radiosurgery of metastatic brain tumors could be safely and effectively performed without immobilizing a patient’s head with an invasive head frame.
Until a few years ago, the standard of care for radiosurgery had required the fixation of a rigid, invasive stereotactic head frame to the skull in order to immobilize the patient and provide a frame of reference for targeting the radiosurgery. Bolted to the skull with surgically implanted pins, the head frame was often associated with discomfort, anxiety and increased recovery time. Today, the rigid head frame has been eliminated from all radiosurgery and radiotherapy treatments involving brain lesions at Precision Radiotherapy Center. Patients are routinely immobilized in a fabricated, noninvasive mask that is custom fit to patient’s head.