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SRS and SBRT Complications and Management

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Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy

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Abstract

Stereotactic radiosurgery (SRS) and, more recently, stereotactic body radiation therapy (SBRT) or stereotactic ablative radiotherapy (SABR) have revolutionized how we treat malignant and benign tumors and disorders. The high-dose and limited number of fractions used (hypofractionation), in many cases, have allowed for equivalent or better control and, in the case with the brain, allowed for the treatment of functional disorders. This is the result of the radiobiology of the hypofractionated doses used, which still remains incompletely understood. However, this same radiobiology may also have an effect on the normal tissue. Improvements in technology has allowed for tighter doses to be delivered to the target, thus minimizing the impact on normal tissue. Understanding the tolerance dose of these organs-at-risk (OAR) is critical in performing SRS and SBRT safely. Although much has been learned, a complete understanding of OAR tolerance doses has yet to be ascertained despite efforts from Timmerman et al. and QUANTEC. Unfortunately, many of the toxicities resulting from normal tissue damage are irreversible. Avoiding these toxicities in the first place is crucial.

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Authors and Affiliations

  1. Department of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA

    Samuel T. Chao, Erin S. Murphy & John H. Suh

  2. Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, USA

    Samuel T. Chao, Erin S. Murphy & John H. Suh

  3. University of Washington Medical Center, Department of Radiation Oncology, Seattle, WA, USA

    Simon S. Lo

  4. University of Washington School of Medicine, Department of Radiation Oncology, Seattle, WA, USA

    Simon S. Lo

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  1. Samuel T. Chao
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  4. John H. Suh
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Correspondence to Samuel T. Chao .

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  1. Mayo Clinic, Radiation Oncology, Mayo Clinic School of Medicine Radiation Oncology, Jacksonville, FL, USA

    Daniel M. Trifiletti

  2. Department of Radiation Oncology, Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, USA

    Samuel T. Chao

  3. Sunnybrook Odette Cancer Centre, Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada

    Arjun Sahgal

  4. University of Virginia, Departments of Neurological Surgery and Radiation Oncology, Charlottesville, VA, USA

    Jason P. Sheehan

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Chao, S.T., Murphy, E.S., Lo, S.S., Suh, J.H. (2019). SRS and SBRT Complications and Management. In: Trifiletti, D., Chao, S., Sahgal, A., Sheehan, J. (eds) Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-16924-4_30

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  • DOI: https://doi.org/10.1007/978-3-030-16924-4_30

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  • Online ISBN: 978-3-030-16924-4

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