Adenoid Cystic Carcinoma Organization International 
Stereotactic Body Radiation Therapy
Basic Explanation
Stereotactic Body Radiation Therapy (also commonly called Stereotactic Body Radiotherapy) is a technique using specialized radiation equipment that allows the radiation oncologist to precisely focus beams of radiation to destroy certain types of tumors that are located in various areas of the body such as lungs. Since the beam is so precise, your radiation oncologist may be able to spare more normal tissue than with conventional external beam therapy. This additional precision is achieved through rigid immobilization of the targeted tumor when possible, flexible treatment delivery, and computer enhanced treatment planning. Although some treatments can be performed in a single treatment, the patients many times receive up to five treatments when necessary. A few of the reported platforms used for many ACC patients, with a high number being for lung tumors have been Varian Trilogy, CyberKnife and Novalis TX.
Reports and Overview Articles About Sterotactic Body Radiation Therapy
Dr. Paul Reed from the University of Virginia published a medical paper, "SBRT 2007 Update Report" that provides a very well done overview of the SBRT treatment platforms with some comparisons of features, applications and medical studies. This provides a very good introduction to the various platforms.
The magazine "Cure Today" had an online article titled "A Direct Hit - Targeted Radiation Theraphy" which addressed the newer radiation platforms as well.
We have created a list of some of the more common SBRT and SRS radiation systems with the particular areas of the body that have been treated with them by some ACC patients. Many of these platforms share the same features and capabilities with many common attributes. If you look at the brochures listed below you can gain a fundamental understanding of the methods utilized. "SBRT and SRS Manufacturer Platforms"
Stereotactic Body Radiation Therapy Manufacturer Models
CyberKnife (Accuray)
A radiation delivery system utilizing a frameless, computer controlled robot type system which is capable of delivering high doses of radiation to tumors with extreme accuracy without damaging healthy surrounding tissue.
CyberKnife Overview Patient Picture Brochure
CyberKnife Synchrony for Lung Tumor Treatment Brochure
CyberKnife Patient Information and CyberKnife Treatment Center Locater
Trilogy (Varian)
Trilogy can deliver all forms of external-beam radiation therapy – from conventional radiation treatment and intensity modulated radiation therapy (IMRT) to the newest and most advanced techniques, such as image-guided radiotherapy (IGRT), stereotactic body radiotherapy (SBRT) and stereotactic radiation Surgery (SRS) for brain tumors. Trilogy’s built-in imaging system can pinpoint the size and location of a patient’s tumor moments before each treatment, and a “respiratory gating” component automatically synchronizes the radiation beam to the patient’s breathing for treating lung mets.
Novalis Tx (BrainLAB/Varian)
This platform has been developed by two of the leading manufacturers in radiation equipment, BrainLAB from Germany, and Varian from California. The Trilogy and Novalis Tx are very similar in features, components and delivery systems. The Novalis Tx shaped beam radiosurgery integrates state-of-art imaging and targeting software with a high energy shaped beam delivery system to obliterate tumors within the lungs, brain and elsewhere, without damaging the normal surrounding tissues. The idea behind Novalis is conceptually straightforward. It combines many precisely shaped beams, each directed toward the tumor, but each from a different direction. By doing this, it is possible to achieve a tumor-killing dose where the beams intersect, while keeping the dose from each individual beam below that which would cause any normal tissue complications.
Novalis Tx Patient Information and Novalis Tx Treatment Center Locater
Tomotherapy (TomoTherapy)
Tomotherapy, literally “slice therapy,'' is the delivery of radiation therapy with intensity-modulated strips of radiation. The method employs a linear accelerator, or another radiation-emitting device, which would be mounted on a ring gantry like a CT scanner. The patient moves through the bore of the gantry simultaneously with gantry rotation. The intensity modulation is performed by temporally modulated multiple independent leaves that open and close across the slit opening.
Tomotherapy Patient Information and Tomotherapy Treatment Center Locater
Synergy S (Elekta) - Elekta Synergy® S
The Synergy S delivers high dose radiation rates with exceptionally fine control and precision. The system enhances avoidance of critical structures during beam delivery with its innovative 3D imaging technology. This technology allows beam adaptation for individual treatment sessions to achieve high precision and excellent target conformance. Digital controls maximize the accuracy of dose delivery without compromise. Elekta Synergy® S offers 1mu dose resolution, with stable dose/ mu calibration and the most accurate IMRT and VMAT delivery available. This platform can be used for some difficult areas such as tumors in the spinal column.
Elekta Synergy for Treating Spine Brochure
Omnibeam (Elekta)
The use of Omnibeam does not require doctors to surgically implant metal markers, but rather uses Real-time Image Guidance (IGRT). The use of live imaging at each treatment session that is significantly more accurate, so Omnibeam can precisely target cancer cells. It uses low-dose 3-D cone-beam CT images for alignment, rather than 2-D X-ray images or high-dose CT scan images. Computer-controlled robotic equipment automatically and instantly corrects for external movement by the patient or internal movement of organs. It reduces the length and number of treatment sessions because the high-powered linear accelerator delivers the highest dose possible precisely at the target to quickly destroy cancer cells. Its accuracy has been proven in numerous studies (in real clinical settings, not labs) and published in peer-reviewed journals.
Primatom (Siemens)
Primatom delivers fast, 3-D tumor localization prior to any treatment fraction, providing an opportunity to escalate dosage, reduce complications, and evaluate the therapeutic effectiveness of treatment. CT functionality in the treatment room provides diagnostic quality images with the patient in the actual treatment position, ensuring routine visualization of the tumor in order to check for anatomical movement. The CT scanner under the control of the therapy department can help to manage the scheduling and acquisition of patients’ CT image data for simulation, planning and treatment purposes.
Proton Radiation
Proton Therapy is a precise form of radiation treatment for cancer and other conditions. By minimizing damage to healthy tissue and surrounding organs, proton treatment is highly successful and results in fewer side effects. Proton beam “skips over” healthy tissue to deposit the radiation energy on the tumor with a high level of precision, thus minimizing damage to good tissue and minimizing side effects. This platform has been used for treating areas that are very close to the brain, lacriminal gland tumors near the eyes, and other difficult areas to precisely focus radiation energy.
Proton Therapy Brochure from Mass General Hospital, Boston MA
Proton Therapy Information from Midwest Proton Radiotherapy Institute Bloomington IN