Cancer Institute A national cancer institute
designated cancer center

Stereotactic Ablative Radiotherapy (SABR) / Stereotactic Body Radiation Therapy (SBRT)

Radiotherapy: What to Expect During Treatment and How to Manage Treatment Related Side Effects

What is Stereotactic Radiotherapy?

Stereotactic Ablative Radiotherapy (SABR), also known as Stereotactic Body Radiation Therapy (SBRT), is highly focused radiation treatment that gives an intense dose of radiation concentrated on a tumor, while limiting the dose to the surrounding organs. It has become a treatment of choice for many patients with limited volume tumors but for whom surgery may not be an optimal treatment. Stanford has experience treating tumors throughout the body, with extracranial sites that include Head & Neck, Thorax, Abdomen (Liver, Pancreas, Adrenal), Pelvis and Bone.

What are is Advantages?

High effectiveness and accuracy. For most indications, local tumor control rates of 90% can be achieved. SABR uses the latest image guidance technologies to ablate tumors with millimeter-scale accuracy. The ability to spare healthy tissue while intensifying the radiation dose is the primary advantage of SABR over other modalities, particularly when critical structures are located near the treatment area.

Non-invasive. SABR is non-invasive and comfortable for the patient.

Convenient, outpatient service. The vast majority of treatments are done as short outpatient visits of 30 minutes to an hour, requiring no hospitalization. Treatment courses are generally completed in 1-5 days, allowing more freedom for your patients' busy lives, even if they are travelling from a distance, and resulting in little or no interruption of their scheduled chemotherapy or other cancer treatments.

Why Stanford?

Unparalleled experience. The first medical linear accelerator in the Western Hemisphere was developed at Stanford and the first patient was treated in 1956. The first CyberKnife was developed at Stanford and the first patient was treated in 1994. We are now one of the only centers with two state-of-the-art CyberKnife systems, and in September, 2010, we treated our 5000th patient. In September, 2010, Stanford also became the first center on the West Coast to treat patients with the new TrueBeam STx system, and the first in the world to deliver SABR using RapidArc and respiratory-gated RapidArc technologies on that system, offering unprecedented focusing of dose and treatment speed.

Multiple SABR treatment platforms. Currently, we are the only center in the world that uses CyberKnife (with Synchrony tracking), Trilogy (with RapidArc and respiratory gating), and TrueBeam STx SABR systems to treat our patients. Having all of these various technologies in one center, combined with our advanced treatment planning imaging capabilities including dedicated 4-D CT and PET-CT, allows us the flexibility to individualize and select the most appropriate therapy for each patient.

Expertise and innovation. Even more important than our cutting-edge technology, Stanford's physicians and treatment team have been pioneering SABR almost since its inception over a decade ago, and continue to drive innovation in this field technologically and clinically. Some of the first prospective clinical trials of SABR for lung tumors and liver tumors were completed at Stanford, and the first prospective clinical trial of SABR for pancreas tumors in the world was conducted at Stanford by our expert physicians and treatment team. We have helped develop clinical guidelines and provide education and training to physicians around the world.

Conditions We Treat with Stereotactic Radiosurgery

Stereotactic radiosurgery is used to treat tumors and conditions within the skull, brain, and skull base including:

  • Brain metastases
  • Acoustic Neuroma
  • Skull base tumors (chordomas, meningiomas, paragangliomas)
  • Trigeminal neuralgia
  • Arteriovenous malformations
  • Many more

Stanford also has experience treating tumors in many locations throughout the body with SBRT, including:

  • Head & Neck
  • Lung
  • Abdomen (Liver, Pancreas, Adrenal)
  • Pelvis
  • Bone
  • Spine

Treatment Process

Before Treatment Begins

Before radiation treatment begins, a patient has a preliminary appointment that allows physicians to prescribe the proper dosage and delivery of radiation.

Once this "set-up" is complete and special blocks have been made to shield healthy organs from the radiation, treatment can be scheduled.

How Stereotactic Radiosurgery Works

Stereotactic radiosurgery uses sophisticated computerized imaging to precisely focus a narrow X-ray beam. Using this method, it is possible to effectively destroy small tumors or close down abnormal blood vessels.

This technique, which is accurate to one millimeter or less, does not require surgery and can be done on an outpatient basis. Radiation can be delivered using either the frameless CyberKnife, or a framed system.

Stereotactic radiosurgery includes the participation of both the surgical and radiation oncology teams who work together to evaluate and treat each patient.

Patients Who Can Receive Stereotactic Radiosurgery

Radiosurgery is limited to lesions that are well-defined and no larger than three to four centimeters. The location of the lesion is also important. For example, lesions too close to radiosensitive structures, such as the optic nerve, are not good targets for radiosurgery.

Features & Advantages

1) CyberKnife
2) TrueBeam

Fewer Side Effects

The ability to spare healthy tissue while intensifying the radiation dose is the primary advantage of SABR over other modalities, particularly when critical structures are located near the treatment area.

Highly Effective and Accurate

For most indications, local tumor control rates of 90% can be achieved. SABR uses the latest image guidance technologies to destroy tumors with millimeter-scale accuracy.

Non-invasive

SABR is non-invasive and comfortable.

Convenient, Outpatient Service

The vast majority of treatments are done as short outpatient visits of 30 minutes to an hour, requiring no hospitalization. Treatment courses are generally completed in 1-5 days, which allows patients to resume regular activities faster. This is true even for patients who are travelling from a distance for treatment. Patients who are also undergoing chemotherapy or other cancer treatments can continue these with little to no interruption while undergoing SABR or SBRT.

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