Stereotactic body radiation therapy (SBRT), also referred to as stereotactic ablative radiation therapy (SABR), is an advanced cancer treatment method in Singapore used to treat small, well-defined tumours in the body. It can be used to treat both primary and metastatic (sometimes referred to as secondary) tumours.
The specialised technology delivers multiple, highly-precise radiation beams to the tumour accurately. This is made possible with the use of advanced imaging technology (e.g. CT scans, PET scans, MRI scans) to identify the precise location of the tumour.
Due to the larger dosage, treatments can be completed within 3 to 5 sessions. Each daily session usually takes no longer than 20 minutes. This cancer treatment is done on an outpatient basis, and patients can resume normal activities thereafter.
Benefits of SBRT radiotherapy
Conventional radiation therapy is typically administered in relatively small doses over several weeks. This can delay or interfere with other cancer treatments, such as chemotherapy. Conversely, SBRT radiotherapy can generally be completed within five or fewer daily sessions. As a result, doctors and patients need not worry about the procedure interfering with the other planned cancer treatments. Furthermore, patients do not require anaesthesia for this treatment. Overall, SBRT radiotherapy can result in better outcomes and fewer side effects for patients compared to conventional radiation therapy.
Risks of SBRT radiotherapy
There are usually fewer side effects with SBRT radiotherapy compared to conventional radiation therapy since only a small area of your body is exposed to radiation. Moreover, these effects are often temporary.
After you are done with your SBRT radiotherapy, you may experience fatigue and skin issues, such as redness, swelling, and itching around the treatment site. Additionally, you may experience side effects specific to your treatment site.
Liver and pancreas
If you are experiencing prolonged side effects from the cancer treatment, you should speak to your doctor immediately.
Treatment and recovery
After the cancer treatment, your doctor will instruct you on how to care for any potential side effects from the SBRT radiotherapy, depending on the treatment site. The doctor will then schedule a follow-up session to assess your response to the cancer treatment and monitor and treat any delayed side effects from the procedure.
To aid in your recovery after your SBRT radiotherapy, we recommend getting as much rest as possible and maintaining a healthy diet. Furthermore, you should avoid sun exposure as much as possible. If you are encountering any side effects from the cancer treatment, you should talk to your doctor immediately.
Consenting to radiation therapy
At our oncology centres, we understand that the healing journey to overcome cancer can be emotionally and physically straining for patients and their caregivers. Therefore, our doctors strive to provide patients with a holistic care environment. We will provide a thorough analysis of your condition to determine the best course of action. In some cases, radiation therapy will be recommended as a standalone procedure or in combination with other treatment plans like chemotherapy or surgery.
However, every radiation therapy procedure, including SBRT radiotherapy, carries inherent risks and side effects. Therefore, it is essential for patients and caregivers to have a basic understanding of the treatment programme. This is why we often encourage patients to seek a second opinion and consult a radiation oncologist to learn about the procedure before consenting to the treatment plan.
Before the patient decides to undergo radiation therapy, they will schedule an appointment with a radiation oncologist to begin the treatment planning process. The oncology doctor will first recommend that the patient undergo a scan to locate the tumour site. With this information, the radiation therapy team can identify the exact treatment area, the optimal dosage required, and the safest way to administer the treatment. Once the tumour has been located, the team will indicate the area with a skin marking.
In addition to skin markings, patients may be asked to undergo mould casting. The body mould is designed to keep the patient still during treatment. As facial and body hair can interfere with the mould casting process, patients may be asked to trim their hair before the procedure.
Patients will also be asked to sign a consent form prior to treatment to grant the oncology doctor permission to administer the treatment. It is essential for patients to have a thorough understanding of the procedure before consenting. Staying informed can help them feel in control of their condition. Moreover, it is crucial for patients to be aware of the risks associated with the available treatment plans. This way, they can weigh their options and make an informed decision.
If you have received a diagnosis, we recommend scheduling an appointment with your oncology doctor as soon as possible to have detailed discussions about what the recommended treatment entails. Here are some questions to ask your oncology doctor during the consultation.
Questions to ask your doctor about radiation therapy
Before radiation therapy
During radiation therapy
After radiation therapy
In addition to these questions, we have also shared a list of common questions patients may have about SBRT radiotherapy. We hope this FAQ guide can shed more light on what to expect from this treatment procedure.
Volumetric modulated arc therapy [VMAT] involves the use of external radiation therapy beams being directed in a series of arcs or angles to allow for greater access to tumour. VMAT allows more difficult tumours, such as the ones wrapped around other important structures, to be targeted precisely.
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SBRT radiotherapy is more intensive and delivers higher doses of radiation per treatment, with the entire treatment delivered in 3 to 5 sessions.
Conversely, IMRT is similar to conventional radiotherapy. The treatment plan is scheduled over more sessions, usually a few weeks, and the radiation beam is delivered to a larger area of the body, which carries greater risks.
SBRT radiotherapy has demonstrated remarkably better outcomes compared to conventional radiation therapy. The success rates for SBRT range from 70% to 80%, as compared to the success rates of 30% to 40% for conventional treatments.
After undergoing SBRT radiotherapy, you may experience fatigue. Rest assured that the effects are temporary, and you should improve about 3 to 4 weeks after your cancer treatment.
SBRT radiotherapy used for treating bone, lung, liver, lymph nodes, and other soft tissue tumours typically involves around three to five sessions.
Preparation for SBRT radiotherapy may vary depending on your condition and the body area being treated. If you are taking medication for other conditions, you should consult your doctor about whether you can take your regular medications the night before or the morning of your procedure. It is also advisable to wear comfortable and loose-fitting clothing during treatment.
Patients undergoing SBRT radiotherapy should take special care of themselves. Let us share some general suggestions that you should take note of when you undergo treatment.
1. Protect your skin
You may experience swelling or soreness of the skin around the treatment area. In specific cases, peeling and blistering may occur. Therefore, it is recommended to clean the treatment area daily with mild soap and warm water. Avoid rubbing and scratching the affected area or using lotions, powders, or scented bathing solutions that may irritate the skin.
2. Get plenty of rest
It is common for patients to experience fatigue after each treatment session. Therefore, we recommend engaging in light exercises to keep yourself active and to get sufficient sleep. This effect is temporary and will wear off gradually once the treatment is over.
3. Maintain a healthy diet
Patients should maintain a healthy and well-balanced diet to provide their bodies with sufficient energy to heal. Your oncology doctor may even advise patients to take nutritional supplements. We recommend consulting a nutritionist who can help you put together an optimal diet plan based on your needs.
4. Stay hydrated
Keep yourself hydrated by drinking plenty of fluids (around 3 litres a day) to help your body heal from the effects of radiation therapy.