In certain situations, a tumor may be in a sensitive enough part of the body that even sophisticated approaches to treatment like IMRT are not enough. Stereotactic radiation therapy can be delivered in a single dose, often called ‘radiosurgery’ because it is performed in a single dose rather than multiple treatments.

Using the 3-D mapping of stereotaxy developing in neurosurgery, SRS has been used for cancer but also for other benign conditions in critical areas of the central nervous system, such as arteriovenous malformations (AVMs), acoustic neuromas, and trigeminal neuralgia. In selected circumstances, fractionated stereotactic radiation therapy is delivered in multiple doses (or fractions) to further decrease the risk of side effects.

Traditionally, SRS has required the use of a head frame to ensure there is no movement during treatment.  Both on linear accelerators and with GammaKnife SRS, a frame has been necessary until very recently.  With IGRT, we can now avoid an unnecessary and uncomfortable step of using a frame in the majority of patients and offer frameless stereotactic radiosurgery.

Prior to 2006, patients in southern New Hampshire would have to travel long distances to received this state-of-the-art treatment. Now, we offer frameless stereotactic radiosurgery as a collaborative multidisciplinary endeavor with the our clinical colleagues in the New Hampshire Neurospine Institute and Southern New Hampshire Radiology Consultants .

Currently, Radiation Oncology Associates provides stereotactic radiosurgery in Manchester but will soon have this service available in Dover in late 2008.