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JAMA Oncology Patient Page
January 10, 2019

Focal Radiation Therapy for Cancer

JAMA Oncol. 2019;5(3):442. doi:10.1001/jamaoncol.2018.5868

Stereotactic Body Radiation Therapy is a focused form of intense radiation therapy.

Radiation therapy (also known as radiotherapy) is a type of cancer treatment where high-energy x-rays are used to kill cancer cells. Patients usually undergo radiation therapy treatments every day, Monday through Friday, 5 days a week, for up to several weeks. Cancer doctors who specialize in giving these treatments are called radiation oncologists.

What Is Stereotactic Radiation?

Recent technological advances have led to a new type of radiation therapy called stereotactic body radiation therapy (SBRT), also known as stereotactic ablative body radiotherapy (SABR). This is a special type of radiation therapy that delivers very precise and intense doses of radiation, typically in 1 to 5 total treatments. With this strategy, the patient receives a much higher dose of radiation during each treatment, and only 1 to 3 treatments are typically delivered per week.

Because the radiation dose for each stereotactic treatment is so high, this approach is only used for small tumors. Examples of cancers well suited for SBRT are early-stage lung cancer or small tumors in the liver, pancreas, bone, kidney, and prostate and adrenal glands.

How Is SBRT/SABR Given?

Each treatment needs to be delivered with precise accuracy to help avoid giving radiation to your nearby healthy tissue. Using information from an initial “simulation” scan, your radiation oncologist designs a complex treatment plan that brings many beams from different angles together in the spot that needs to receive a high radiation dose. It is important that your body is in exactly the right position for each treatment. Before each treatment, your radiation team will ensure that the radiation is set up uniquely for your body and your tumor. This process may include many steps:

  • Using a customized cushion (known as a mold) for you to lie in, so you are in a comfortable and stable position through treatment.

  • Putting a belt around your stomach.

  • Checking the position of your body with laser beams.

  • Checking the position of the tumor with a CT scan or MRI scan before treating you.

  • Checking how deeply you are breathing.

  • Checking how the tumor moves while you breathe, using a 4-dimensional CT scan (or CT movie), or in some cases by looking at special gold seeds called fiducials that are put into the tumor prior to radiation treatment, which then can be seen on the CT scan.

Which Brand and Platform Are Best?

There are many different types of specialized radiation machines that are available for stereotactic radiation. Just as the exact model of car you take to get to your destination does not matter as long as it is safe and reliable, the particular brand and platform for radiation is not a meaningful difference when so many can deliver high-quality radiation therapy.

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Section Editor: Howard (Jack) West, MD.
The JAMA Oncology Patient Page is a public service of JAMA Oncology. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA Oncology suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call (312) 464-0776.
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Article Information

Published Online: January 10, 2019. doi:10.1001/jamaoncol.2018.5868

Conflict of Interest Disclosures: Dr Jagsi reports grants from the National Cancer Institute, the Komen Foundation, the Greenwall Foundation, the Doris Duke Charitable Foundation, and the Blue Cross Blue Shield of Michigan/Michigan Radiation Oncology Quality Consortium; and personal fees from Vizient, Amgen, and Equity Quotient outside the submitted work. No other disclosures are reported.