Name of the Procedure:

Stereotactic Body Radiation Therapy (SBRT), Treatment Delivery (Per Fraction to 1 or More Lesions)

Summary

Stereotactic body radiation therapy (SBRT) is an advanced form of radiation treatment that delivers highly precise radiation doses to cancerous tumors in the body. It is often used to treat small to medium-sized tumors in various organs with precision, minimizing damage to surrounding healthy tissues.

Purpose

SBRT is primarily used to target and destroy cancerous tumors located in the body, such as those in the lungs, liver, spine, or other organs. The goal is to effectively treat the tumors with high-dose radiation while preserving the health of surrounding tissues. The treatment course does not exceed five fractions (sessions).

Indications

• Small to medium-sized tumors in organs such as the lungs, liver, kidneys, or spine.
• Patients who are not candidates for surgery due to other health conditions.
• Tumors that are well-defined and located away from critical structures.
• Recurrent tumors previously treated with conventional radiation.

Preparation

• A comprehensive imaging study (e.g., CT, MRI, or PET scans) for precise tumor location.
• Creation of a custom immobilization device to keep the patient still during treatment.
• Pre-procedure planning session to map the exact coordinates of the tumor.
• Specific instructions on fasting or medication adjustments may be given if sedation is needed.

Procedure Description

1. The patient is positioned on the treatment table with the aid of the immobilization device.
2. Image guidance tools, such as X-rays or CT scans, are used to verify the tumor's exact location.
3. High-energy radiation beams are delivered from multiple angles to converge precisely on the tumor.
4. The procedure is typically repeated across up to five sessions, with each session termed a fraction.
5. Throughout the procedure, real-time imaging ensures the accuracy of the radiation delivery.

Duration

Each session typically lasts between 30 minutes to an hour, depending on the complexity and number of lesions being treated.

Setting

SBRT is usually performed in a specialized radiation oncology department within a hospital or an outpatient cancer treatment center.

Personnel

• Radiation Oncologist
• Medical Physicist
• Radiation Therapist
• Radiologic Technologist
• Nurses and support staff

Risks and Complications

• Fatigue
• Skin reactions in the treated area
• Temporary increase in pain or discomfort
• Rare risks include damage to nearby organs or tissues, infection, or radiation pneumonitis (for lung treatments).

Benefits

• Precisely targets cancer cells while sparing surrounding healthy tissue.
• Non-invasive alternative to surgery.
• Typically involves fewer sessions than conventional radiation therapy.
• High control rates for small or medium-sized tumors.

Recovery

• Minimal downtime; most patients can return to normal activities shortly after each session.
• Possible mild side effects like fatigue or skin irritation.
• Follow-up appointments to monitor the tumor’s response to treatment with imaging studies and clinical evaluations.

Alternatives

• Conventional radiation therapy: Longer course with more sessions.
• Surgical resection: May be an option for operable tumors.
• Chemotherapy: Systemic treatment for certain types of cancer.
• Ablative therapies (e.g., radiofrequency ablation): Minimally invasive, localized treatment options.

Patient Experience

During the procedure, the patient should remain as still as possible. Most patients do not experience significant discomfort during the treatment. Post-procedure, patients might feel fatigued or have minor skin irritations, which can be managed with over-the-counter medications and skin care guidance. Comfort measures are provided, and supportive care is available during and after treatment. Each patient’s experience may vary based on individual health and tumor characteristics.