Overview

Before you start stereotactic radiotherapy (SRT), your scans and medical history will be reviewed by your team of healthcare professionals. They will help and support you throughout your treatment.

They will prepare your individual treatment plan which will be based on your condition and tumour type.

SRT is for small tumours which might be difficult to remove by having surgery, or where surgery has a high risk of side effects.

Your treatment plan will be discussed with you in more detail before you start treatment. We will also discuss if there are any other treatment options that are suitable for you.

Stereotactic radiotherapy (SRT)

Radiotherapy uses high energy X-rays to treat tumours. It works by damaging the tumour cells so that they die or stop growing.

Side effects generally only affect the area where you are having treatment.

SRT is a very accurate way to give a high dose of radiation to small areas of the brain. It targets a very precise point. This allows us a better chance to control the tumour and reduces damage to surrounding healthy tissues.

It is given in small doses called fractions. The number of fractions you receive (between 1 and 5) will depend on which course of treatment is best for you.

• When 1 fraction is given it is called stereotactic radiosurgery (SRS).
• When more than 1 fraction is given it is called stereotactic radiotherapy (SRT).

Before radiotherapy starts

Pacemakers

Tell us as soon as possible if you have a pacemaker as you will need to have a pacemaker check.

Shunts

If you already have a ventriculoperitoneal shunt (V-P) fitted, we will need to know if it is a programmable type of shunt. If you have been given an information card please bring this with you.

Pregnancy

If you’re able to become pregnant and have regular periods we will ask if you are pregnant.

It is very important that you are not, and do not become pregnant while you have radiotherapy planning and treatment.

If necessary, speak to your GP about types of contraception suitable for use during radiotherapy.

Tell us immediately if you think you might be pregnant at any time during your course of treatment.

Preparing for your treatment

Before your treatment you will have:

• a close fitting mask made
• a CT scan
• an MRI scan

Making your mask

You will need to wear a close fitting plastic mask every time you have radiotherapy treatment. This makes sure that your head is kept still so that the treatment can be given accurately.

You will be given an appointment to have your mask made. This will be in the mould room and it usually takes about an hour to make your mask.

The mask needs to be a very snug fit. Making the mask is painless and you are able to breathe normally.

You will need to prepare, so before your appointment:

• Have a shave and completely remove all facial hair (beards and moustaches).
• If you are planning a haircut, this must be done before the fitting.
• If you wear make-up or have false eye lashes you will need to remove these. They can be reapplied when you have finished your treatment.

At your appointment

You will be asked to remove your shoes and any bulky clothes.

We will help you to lie flat on your back on a treatment table. This is the position that you will be in for the CT scan and for all of your treatments.

To make your mask, a thin sheet of plastic is put in warm water to soften it. It is then put over your face and moulded to your forehead and chin. It feels like having a hot cloth on your face.

The mask will become rigid as it dries and might get slightly tighter. This is normal and will help to keep your head still.

Your mask will be removed once it is set. You will wear your mask for your CT scan but not for your MRI scan.

CT scan

A CT scanner is a special X-ray machine that produces a series of detailed images showing the structures in your head.

You can eat and drink normally on the day of your scan and throughout your treatment appointments. There is no harm in you being around other people.

Read more about having a CT scan.

During the CT scan

You will lie on the scanning table in the same position as when you had the mask made. Your mask will be placed over your face and secured to the table.

You will be able to breathe normally with the mask on and you do not need to hold your breath.

A radiographer might need to take a photograph of you in the mask. This is only used to set up your treatment.

When you are in position, the table will be raised to go through the scanner. The radiographers will leave the room but they will be watching you at all times on closed circuit television (CCTV).

You will feel the bed slowly move in and out of the scanner and hear the machine buzzing. The scan should only take a few minutes.

After the CT scan

Once the scan is completed, the radiographers will come back into the room and remove the mask.

You will be helped down from the scanning table and you can then get dressed. You will be given instructions about your MRI scan.

MRI scan

An MRI scan is also needed to plan your treatment. You do not need to wear your mask for this scan.

Read more about having an MRI scan.

Before the MRI scan

We will use a contrast called Gadolinium, which is a fluid that shows up on MRI images, during the scan. It is used to make images clearer.

Read more about Gadolinium contrast.

Your treatment plan

Your healthcare team will review the results of your CT and MRI scans, along with your medical history. They will decide on the best treatment plan for you.

You will receive a phone call from one of the radiographers to talk to you about your treatment plan. You will be able to ask any questions.