Stereotactic Radiosurgery (SRS) Treatment 

Stereotactic radiosurgery (SRS) is an incisionless procedure that involves the precise delivery of high-intensity radiation to very small targets in the brain. It is used to treat cancer and various neurological conditions. At Tampa General Hospital, SRS is done on a CyberKnife, one of the most advanced technologic advancements, providing very precise treatment. The CyberKnife at Tampa General does not require any frames or pins, making it more comfortable. Importantly, there is no true "surgery" in SRS, no incisions, no bleeding, and anesthesia is not typically needed. Shaving one's hair is also not needed. It is non-invasive and painless, making it an attractive option for many patients. 

What Conditions Can Be Treated With SRS? 

Typically completed in a one-day session, stereotactic radiosurgery may be used to treat certain brain tumors and arteriovenous malformations (AVMs). In general, the use of SRS is limited to the head and neck, which are the only areas of the body that can be sufficiently immobilized to allow for the precise and accurate delivery of high-dose radiation.

Functional Radiosurgery refers to when SRS is used specifically to treat neurologic and psychiatric conditions, movement disorders, certain types of seizure disorders, and various pain syndromes. 

How Is SRS Delivered? 

Different technologies may be used to deliver radiation to the brain during stereotactic radiosurgery, including: 

• A linear accelerator (LINAC) – X-ray beams (photons) are used to treat cancerous and noncancerous brain abnormalities.  
• A Gamma Knife machine – Approximately 200 tiny beams of radiation are focused on a brain tumor or AVM with submillimeter accuracy. 
• Proton beam therapy – Instead of X-rays, protons are precisely targeted to a brain lesion. 

What to Expect With SRS 

If you are a candidate for SRS and elect to proceed after reviewing all treatment options, you will be asked to come in for an initial planning study where a custom thermoplastic mask or frame is created. A series of highly detailed images will then be taken of your brain. The resulting images will be input into a computerized planning system to help the radiosurgery team determine the precise areas to treat, the appropriate doses of radiation and the optimal focus of the radiation beams. You will be scheduled to come back for treatment at a later date. During this time, your Tampa General team will design a customized plan for your condition. The target is chosen by a multidisciplinary team that may include a neurosurgeon, a radiation oncologist and a medical physicist, depending on your diagnosis. Treatment duration depends on the condition being treated, but usually treatment is just about 45 minutes. Some unique conditions, however, require patients to come on two separate days, each day for 45 minutes. This is done on an outpatient basis and you are good to go home after treatment with no recovery period. You will be scheduled to follow up with your doctors for future exams and assessments. 

Is SRS Effective?

Overall, SRS has been shown to be highly effective for many conditions, convenient, and with minimal toxicity. In the case of a brain tumor, the radiation damages the DNA of the tumor cells, rendering them unable to reproduce or function properly. Unlike traditional surgery, stereotactic radiosurgery does not remove a tumor or an AVM. Instead, the cells will eventually die. In the case of an AVM, the radiation causes the blood vessels to thicken and close off over time.

One of the disadvantages of functional SRS is that it does not work immediately unlike surgery, as it takes weeks and sometimes months for the benefits to really become apparent. However, while it has a latent period, the non-invasive nature and minimal side effects make it a great choice for many patients, particularly those who are not ideal surgical candidates or do not wish to have surgery.

What Differentiates Us?

We work with a multidisciplinary team to get the best treatment option specific to you. Our Cancer Institute has been named One of the Nation's Best Hospitals for Cancer Care by U.S. News & World Report 2024-25 and is named one of America's Best Cancer Hospitals by Newsweek.  Our Neuroscience Institute has earned “high performing” designation for Neurology & Neurosurgery by U.S. News & World Report for 2024-25, meaning we are ranked among the top 10% of hospitals in the nation. Tampa General Hospital is the only hospital in the region to use SRS for functional neurosurgery. There are only a few others in the state of Florida to do so.