How Stereotactic Radiosurgery Helps Patients with Inoperable Brain Tumours

A brain tumour diagnosis often brings emotional and medical challenges. However, hearing it's inoperable usually carries a heavier emotional weight. For many patients, surgery is not possible due to the tumour's location in the brain or other health-related factors. However, significant advancements in medical technology are emerging, along with new and effective treatment options. 

Stereotactic Radiosurgery (SRS) is one of the most impactful developments in recent years. Clinical studies state that SRS achieves tumour control in up to 90% of patients with small, well-defined brain tumours. While the term implies a surgical procedure, SRS is performed without any incisions or physical intervention. Without making any incisions, it eliminates tumour cells using focused radiation beams. 

In this blog, we'll explore how SRS is changing the treatment for inoperable brain tumours, its benefits, and its growing role as the latest technology in brain tumour care, alongside some global insights into its use around the world.

Why Some Brain Tumours Are Inoperable?

Even though brain tumours are often treated with surgical excision, not all tumours can be eliminated. Surgery may be dangerous or possibly impossible for a number of reasons:

• Tumour Location: Tumours located near vital areas, such as the brainstem or deep within the brain, pose a higher risk during surgery.
• Tumour Behaviour: Some tumours spread out and attach themselves to healthy tissue, making it nearly impossible to remove them without causing brain damage.
• Health Conditions: Due to their old age or underlying medical issues, some patients may not be well enough for major surgery or general anaesthesia.

In these situations, stereotactic radiosurgery for brain tumours is a non-invasive option that can reduce or stop tumour development while maintaining brain function and quality of life.

What is Stereotactic Radiosurgery?

Brain stereotactic radiosurgery (SRS) is a highly precise radiation therapy for brain tumours. SRS applies a strong, targeted radiation dose to the tumour spot, instead of using instruments to remove it. The main goal is to either kill or restrict the growth of cancer cells without harming the healthy brain tissue surrounding them.

SRS usually concludes in one to five sessions, as compared to the several weeks and numerous sessions required for standard radiation therapy.

How does it work?

SRS works in the following ways:

• Imaging: High-resolution MRI or CT scans are used to precisely locate the tumour.
• Planning: The safest and most efficient angles for radiation delivery are mapped by specialised software.
• Targeting: Numerous radiation beams are aimed at the tumour, all of which converge on the same spot.
• Treatment: While the machine administers the painless treatment, the patient remains still. There is no bleeding, cutting, or hospitalisation.

These carefully coordinated steps ensure that SRS delivers powerful treatment with pinpoint accuracy, maximising effectiveness while minimising harm to healthy brain tissue.

What are the Different Types of SRS Systems?

Modern stereotactic radiosurgery uses a number of technologies, such as:

• Gamma Knife: The most effective instrument for treating small tumours located deep within the brain, particularly when surgical access is challenging.
• CyberKnife: A robotic system that monitors tumours during treatment using real-time imaging.
• LINAC (Linear Accelerator): A versatile and accessible technology used for treating tumours of the body and brain.

The size, type, and location of the tumour, as well as the resources available at the treating institution, all influence the equipment selection.

This image shows the headframe used in Gamma Knife treatment, which helps deliver radiation precisely to the target and remove a tumour or lesion at an exact location.

Why is SRS a Game-Changer for Inoperable Brain Tumours?

SRS offers many benefits that make it a preferred option for patients who cannot undergo traditional surgery:

• Painless and Non-Invasive: During this painless procedure, patients remain awake. No anaesthetic, stitches, or incisions are made.
• Low Risk, high precision: By employing computer-guided technologies and precise imaging to target tumours with submillimeter accuracy, SRS reduces injury to surrounding brain areas.
• Minimal Recovery Time: Most patients resume their normal activities within 24 to 48 hours. Extended hospital stays are not necessary.
• Fewer Side Effects: Since radiation is aimed precisely at the tumour, side effects, including fatigue, nausea, or cognitive impairments, are fewer than with conventional radiotherapy.
• Flexible and Repeatable: SRS can occasionally be repeated or used in combination with treatments like chemotherapy or immunotherapy.

These benefits combine to make SRS a safe and efficient treatment option for inoperable brain tumours.

Who Can Benefit from SRS?

SRS is particularly beneficial for:​

• Patients with surgically challenging small to medium-sized tumours.
• Individuals with metastatic brain tumours originating from cancers in other parts of the body.
• Patients whose age or other health issues make them unsuitable candidates for surgery.
• Situations where cancers return after previous treatments.

A multidisciplinary team evaluates each case to determine whether SRS is a suitable treatment option or not.

Are There Any Risks?

Stereotactic radiosurgery (SRS), like any medical procedure, has inherent risks, but fortunately, significant adverse effects are uncommon. 

Mild headaches, exhaustion, or temporary brain swelling (oedema) are possible side effects for some patients following the procedure. In rare cases, short-term issues such as blurred vision, speech difficulties, or changes in movement may occur, depending on the tumour's location.

In most cases, these symptoms are temporary and can be easily controlled with standard medications. Overall, SRS has proven to be a safe and well-tolerated treatment, with global studies showing a strong track record of effectiveness and minimal complications.

This graph shows the common side effects of stereotactic radiosurgery (SRS), with headache and fatigue being the most frequently reported.

What is The Future of SRS? 

There are significant developments in stereotactic radiosurgery as cancer treatment becomes more specific:

• AI-based planning adjusts the treatment course based on the type of tumour and the individual's unique brain anatomy.
• In clinical trials, the combination with immunotherapy is showing potential results.
• To determine who may benefit most from SRS, genetic profiling is being used.

According to the latest technology in brain tumour care, it can be treated in the future using a combination of targeted medications, precision radiotherapy, and patient-specific knowledge.

Final Thoughts: A New Era of Hope

For many years, patients with inoperable brain tumours had few, frequently challenging options. But today, Stereotactic Radiosurgery is rewriting that story, offering a non-surgical, highly targeted treatment that is both effective and minimally invasive to the body.

This innovative approach isn't just extending lives; it's helping patients maintain their quality of life, clarity, and everyday routines. It's a shining example of how far medical technology has come.

Consider talking to your healthcare team about SRS if you or a loved one is coping with an incurable brain tumour. Perhaps this breakthrough will open up new opportunities and a positive attitude.