Brain metastases, sometimes because of lung cancer, breast cancer, prostate cancer, pancreas cancer, normally can be treated with surgery.

But for brain metastases, surgery is a method that we don’t prefer too often because it is a little hard. Therefore, it’s possible to perform stereotactic radiosurgery instead. Advantage is that we perform the treatment in one day. For example, you come on Monday, we make the plan, we perform the treatment on Tuesday and Tuesday evening you get on the plane and go home. Lung cancer, breast cancer, malignant melanoma or various tumors usually cause brain metastases. For brain metastases, surgery or stereotactic radiotherapy may be preferred. Of course, stereotactic radiotherapy is much easier than surgery.

For example, here you see a patient who has brain metastases, here you see two different metastases, a third, a fourth and a fifth. So, for this patient, there are five different metastases in the brain. With a Linear Accelerator, with Elekta Versa HD, the treatment is done in 1 day for 5 different metastases. Normally, surgery cannot be done for more than two metastases but here there are five different metastases. Treatment is done in one day and treatment lasts about 15 minutes. That is a great advantage. The targets are very small. You give a really important dose in 1 day. And that way you don’t touch the brain, you can protect the mental functions of the patient.

This is another patient with lung cancer which metastasized in the brain. As you see there are metastases in different locations. Important thing is, for this type of metastases we can give a very high dose. But we can’t give a very high radiation. Because there are critical organs around these metastases. What we do with Elekta Versa HD is ordering the machine to give a high dose here, and a little smaller here, you see the different colors. High dose for here, for here dose is a little lower. We perform the treatment for 4 different targets in 15 minutes within a day.

Doctors do not need to spend a lot of time to irradiate all metastases. We did an irradiation but all the tumors take different doses. This is the difference of stereotactic radiotherapy.

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Why  Stereotactic Radiotherapy for Lung Cancer?

Lung cancer is a type of cancer that the treatment can be done rather with surgery. If the tumor is not small. Because in small cell lung cancer, the physcians prefer radiotherapy and chemotherapy treatments at the same time.

In tumors which are not small cells, we rather prefer surgery. But we can prefer after surgery. Sometimes before surgery radiotherapy and chemotherapy.

The problem is that: Sometimes, there are lung cancers which are T1, T2 tumors that are not advanced and have not metastasized to the mediastinal region. For these tumors normally we perform surgery and get fine results.

But if the patient has cardiac problems, which is something that prevents the surgery, we need to perform a treatment that is equal to surgery.That is stereotactic radiotherapy.

When Stereotactic Radiotherapy for Lung Cancer is performed?

Normally, in lung cancer, if the tumor is small and does not have metastasis in the mediastinal region. It’s a T1, T2 Tumor. Normally these tumors are operable tumors. In reality treatment is surgery. But sometimes patients have heart problems. Sometimes there are other problems or if the patient does not prefer the surgery. In that case stereotactic radiotherapy, can be done in 3-5 days.

It depends on the location of the tumor. And in 3 days, you give a dose that is equivalent to 6-7 weeks. This is a really important dose for this method of radiotherapy. You have the results that are roughly equal to surgery. So now we have a way to treat patients who can’t go through the surgery with stereotactic radiotherapy. (In 3 or 5 days.)

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There are several ways to perform stereotactic radiotherapy. We use either Gamma Knife, Cyberknife or we use Linear Accelerators like Elekta Versa HD.

This is a machine that is really well developed. And all radiotherapy can be done whether it is conventional or stereotactic radiotherapy with the same machine. As you see, machine can move in this direction with the table or as you can see like this. During treatment, the machine makes a turn like this. For each patient, we use a special mask that is prepared only for that patient. Thus, stereotactic radiotherapy lasts about 10-15 minutes.

What’s the difference?

With the Gamma Knife or Cyberknife, stereotactic radiotherapy for either the brain or the lung, lasts about 40 minutes or 1 hour. With this machine here, we perform the same treatment in 10 or 15 minutes. For example, stereotactic radiotherapy for the prostate. It is a therapy that lasts a little long but with Elekta Versa HD we perform the same treatment in a very limited time. It is very important for the patient who suffers from cancer. Because the more patients have problems with pain, the more they can’t stay long on the table. And that’s why the Elekta Versa HD is highly ideal for stereotactic radiotherapy.

In Istanbul Med Assist your comfort during or after all kinds of procedures are our priority. Whether you are looking for more information, an initial evaluation or a second opinion, do not hesitate to contact with us via from Whatsapp on +90 530 884 47 22 and we will get back to you as quickly as we can.

If you want to perform a treatment that is very specific for cancer and if you want to protect the health tissues, you have to perform treatment in a machine which has Cone Beam CT or Cone Beam Tomography.

This is a kind of tomography that is in Elekta Versa HD. With this machine, it’s possible to control the tumor and healthy tissues every day. Because normally organs move with the tumor. For example the rectum, the bladder, the intestines and the tumor are in different positions every day. There must be controls with Cone Beam CT every day. It’s necessary to see the bladder, the rectum and the tumor. But if you perform the treatment with a machine without Cone Beam CT, you can’t see the tumor in its current position and the position of the healthy tissue. For example, here, you see a patient with lung cancer. To perform the stereotactic radiotherapy treatment for the lung, you have to use a machine that shows the tumor in 4 dimensions. You see that during breathing the tumor moves like this. If you see the tumor moving during treatment, you are always in an area that is well protected. Because you irradiate the tumor without touching the lung. So, after treatment patients have problems at the minimum. As you can see the tumor is moving during treatment.

If you have a linear accelerator that has the ability to see the tumor in four dimensions, you can perform a very targeted treatment. You give a big dose here but you don’t touch the lung. With this method here, one can perform a treatment without needing to perform surgery, only in 3 days or 5 days, sometimes 8 days. And without any side effects.

In Istanbul Med Assist your comfort during or after all kinds of procedures are our priority. Whether you are looking for more information, an initial evaluation or a second opinion, do not hesitate to contact with us via from Whatsapp on +90 530 884 47 22 and we will get back to you as quickly as we can.

I’m Tayfun Hancilar, MD. I’m a radiotherapist. I have been working for 32 years and i worked 2 years in Paris in 92 and 94 with Professor Schlienger and Professor Laugier. I worked mainly on stereotactic radiotherapy. I returned to Turkey in 94 and since then I performed a lot of treatment on stereotactic radiotherapy.

Stereotactic radiotherapy or stereotactic radiosurgery. This is a treatment that targets the tumor thoroughly and preserves healthy tissues much more than traditional radiotherapy. For stereotactic radiotherapy we can use different machines. For example, firstly there is Gamma Knife and there is also Cyberknife. Mostly, we were using linear accelerators. For stereotactic procedure, I prefer to perform the treatment with Elekta Versa HD. Because it is the machine that makes procedure much faster than other machines. For example, the Gamma Knife, it takes about an hour to perform a treatment for brain metastases. One can perform the same treatment with Elekta Versa HD in 10 minutes.

What is the difference between stereotactic radiotherapy and conventional radiotherapy?

We can perform the treatment in 1 day or in 5 days. We give a very high dose to a well-targeted tumor to protect healthy tissue, it’s equal to a 6- or 7-week treatment in conventional radiotherapy. It’s a quicker and easier treatment and we can protect a lot more healthy tissues than conventional radiotherapy. The tumors we perform stereotactic radiotherapy on, mostly are brain metastases, inoperable lung cancer. We perform stereotactic treatment in metastases of the adrenal glands, bone metastases, sometimes in pancreatic cancer or in prostate cancer. For example, for prostate cancer, normally, treatment takes about 8 weeks with conventional radiotherapy. The same treatment can be done for prostate cancer in 10 days with 5 fractions.

In Istanbul Med Assist your comfort during or after all kinds of procedures are our priority. Whether you are looking for more information, an initial evaluation or a second opinion, do not hesitate to contact with us via from Whatsapp on +90 530 884 47 22 and we will get back to you as quickly as we can.