What is Stereotactic Therapy?

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What is the meaning of Stereotactic Therapy?

Stereotactic therapy is an advanced technique of radiation therapy that enables the delivery of strong and targeted radiation doses to small regions, destroying a small group of cells effectively.

Stereotactic therapy is mainly used for the treatment of tumors and other problems in the brain, neck, liver, lungs, spine, and other body parts. There are no incisions or cuts involved in this process. Instead, stereotactic therapy makes use of 3D imaging to target the high radiation doses to the affected area with the least impact on the surrounding healthy tissue.  When stereotactic therapy is used to treat tumors in body areas other than the brain, it is known as stereotactic body radiotherapy (SBRT) or stereotactic ablative radiotherapy (SABR).

In this article, we will be discussing in detail stereotactic therapy.

• What are the different types of Stereotactic Therapies?
• What is the purpose of Stereotactic Therapy?
• What is the diagnostic procedure before Stereotactic Therapy?
• How to prepare for Stereotactic Therapy?
• What is the procedure for Stereotactic Therapy?
• How to care after Stereotactic Therapy?
• What are the risks of Stereotactic Therapy?
• What is the cost of Stereotactic Therapy in India?

What are the different types of Stereotactic Therapies?

The different types of technology used for the delivery of radiation during stereotactic therapy are:

Linear accelerator (LINAC) machine:

• X-rays or photons are used to treat cancerous and non-cancerous abnormalities in the brain and other body parts.
• Stereotactic therapy may be provided in a single session or over three to five sessions for larger tumors, known as fractionated stereotactic radiotherapy.

Gamma Knife machine:

• 192 or 201 small beams of gamma rays are used to target and treat the cancerous and non-cancerous abnormalities of the brain.
• It is usually used to treat small to medium tumors and brain lesions associated with different conditions.

Proton beam therapy machine:

• It can help in treating brain cancers in a single treatment session using stereotactic therapy, or fractionated stereotactic therapy may be used to treat body tumors over many sessions.

What is the purpose of Stereotactic Therapy?

Stereotactic therapy is used for the treatment of the following conditions:

• Acoustic neuroma (a nerve tumor between the brain and the ear)
• Brain tumors, including malignant (cancerous) and benign (non-cancerous) tumors
• Certain types of eye cancer
• Arteriovenous malformations (an abnormal connection between the arteries and veins) and other disorders of the blood vessels in the brain
• Brain tumor causing epilepsy (a disorder causing a disturbance in the nerve cell activity, leading to seizures) ( Know more about- What is Epilepsy ? )
• Parkinson’s disease (a brain disorder causing uncontrollable shaking, stiffness of muscles, and problems with balance and coordination)
• Pineal tumors of the pineal gland (a hormone-producing gland located near the center of the brain)
• Pituitary tumors of the pituitary gland (a hormone-producing gland situated near the center of the brain and responsible for the various metabolic processes of the body)
• Skull base tumors ( Know more about- What is Skull Base Surgery ? )
• Psychoneurosis (mental disorders)
• Spinal tumors, benign as well as malignant
• Trigeminal neuralgia (a nerve disorder that leads to severe facial pain)
• To enhance conventional radiation therapy
• As a treatment option when other treatment options have failed
• Control or treat a recurrent spinal tumor
• Control or treat the remaining portion of a tumor following a surgery 

What is the diagnostic procedure before Stereotactic Therapy?

• Physical examination: The doctor checks the physical health status of the patient. The patient’s symptoms and medical history are noted by the doctor.
• Imaging tests: Imaging tests like CT scans and MRI scans are done to create clear images of the cancerous organ.
• Cerebral angiograms: The doctor inserts a small tube in a blood vessel in the groin region and threads it to the brain with the help of x-ray imaging. The doctor will inject a contrast dye into a blood vessel during CT scans or MRI scans to view the blood vessels and check the blood circulation.
• Endoscopy: A tube with a camera on one end is used by the doctor to examine the affected organ internally. ( Know more about- What is Endoscopy? )
• Blood tests: These tests help to check for the presence of any medical disorders that the patient may have.
• Biopsy: The doctor surgically excises the suspected tissue growth and sends it to the laboratory for evaluation under the microscope, to check for the presence or absence of cancer cells and the type of cancer cells that may be present.

How to prepare for Stereotactic Therapy?

• Tell your doctor if you have any medical ailments.
• Tell your doctor if you are currently taking any medications, herbs, or supplements.
• If you are allergic to iodine or shellfish, which are related chemically to the special dyes used during the procedure, tell your doctor about the same.
• Do not wear makeup, jewelry, hair products, eyeglasses, contact lenses, and dentures before the treatment.
• Tell your doctor if you have any implanted medical devices in your body, like a pacemaker, aneurysm clips, neurostimulators, stents, or artificial heart valves. ( Know more about- What is Heart Valve Diseases? )
• Ask your doctor if you can take your regular medications the night before or the morning of the procedure.
• Do not eat or drink anything after midnight, the day before the procedure. 
• Before the procedure starts, a lightweight head frame will be attached to your head using four pins. It helps in stabilizing your head during radiation therapy and also acts as a point of reference to focus the radiation beams. The head frame is not needed in cases of LINAC stereotactic therapy.
• CT scans, MRI scans, or cerebral angiograms are the different imaging tests that may be performed to check the location of the tumor and any abnormality related to the head frame.
• The procedure of immobilization of the patient and then determining the best placement of the body to align it with the radiation beams is known as simulation.
• The doctor may mark the areas in or near the tumor using a marker or tattoo.
• According to the results of the brain scan, the doctor’s team will plan on the areas that need treatment, radiation dosages, and how the radiation beams are focused to treat the treatment areas.

What is the procedure for Stereotactic Therapy?

• Children may be anesthetized for the procedure. Adults are usually awake during the procedure but may be given a mild sedative to help the patient relax.
• If a Gamma Knife machine is being used, you will be lying on a bed that slides into the machine, and the head frame is attached securely to the bed frame.
• The machine normally does not move during treatment, instead, the bed moves within the machine.
• The entire procedure may take about one to four hours to complete, depending on the shape and size of the target. Treatment of the brain using LINAC will be quicker.
• Unlike Gamma Knife, the LINAC machine will move and rotate around the target during treatment for the delivery of radiation beams from different angles. The treatment takes less than one hour to complete.
• You will not feel anything during the procedure and can speak to the doctors via a microphone.

How do care after Stereotactic Therapy?

• The head frame, if used during the procedure, is removed.
• It is normal to have mild tenderness and bleeding at the pin sites after head frame removal.
• Normally, you will be able to go home about one hour after the procedure.
• You can resume your normal activities the day after the procedure if there are no complications. 
• If you have any complications, you may need to stay in the hospital overnight for monitoring.
• If you experience headache, vomiting, or nausea after the procedure, you will receive the appropriate medications for the same. ( Know more about- What are Headache Tablets ? )
• The effect of stereotactic therapy will be seen gradually, over a couple of days or months.
• Follow-up exams with the doctor are recommended, where CT scans or MRI scans will be performed to see the effect of the treatment on the tumor.

What are the risks of Stereotactic Therapy?

The complications of stereotactic therapy may include:

• Fatigue
• Swelling near the site of treatment
• Nausea
• Headache
• Vomiting
• Diarrhea ( Know more about- What is Diarrhea ? )
• Cough
• Loss of hair
• Scalp irritation, redness, or sensitivity
• Skin irritation, itching, dryness, blistering, or peeling
• Brain or neurological problems
• Bleeding 
• Muscle pain
• Vision problems
• Nerve damage
• Paralysis
• Fistula (holes between the tissues or organs)
• Vertebral (spinal bone) fracture after spinal treatments
• New cancer development (rare)

What is the cost of Stereotactic Therapy in India?

The total cost of stereotactic therapy in India can range from around INR 3,00,000 to INR 4,00,000. However, many prominent hospital doctors in India specialize in proton therapy. But the cost varies across different hospitals. 

If you are coming from abroad, apart from the cost of stereotactic therapy, there will be an additional cost of living in a hotel and the cost of local travel. So, all the expenses come to a total of INR 3,90,000 to INR 5,20,000. 

We hope that we could answer all your questions regarding stereotactic therapy through this article.

If you need more information about stereotactic therapy, you can contact a Radiation Oncologist.

We only aim to provide you with information through this article. We do not recommend any medication or treatment to anyone. Only a qualified doctor can give you good advice and the correct treatment plan.