Stereotactic Radiosurgery

There is growing evidence worldwide that stereotactic radiosurgery is a safe and effective treatment choice for a number of conditions, including certain primary and metastatic brain tumors, acoustic neuromas, meningiomas, and arteriovenous malformations in deep, inaccessible areas of the brain.

Combining radiation oncology and stereotactic expertise, stereotactic radiosurgery is a precise, technologically sophisticated procedure which can be performed on an outpatient basis, a significantly less taxing and better tolerated form of therapy than repeated visits to the medical center for conventional radiation therapy. Because stereotactic radiosurgery requires no anesthesia and no incision, the procedure is also less stressful than surgical approaches.

Stereotactic Radiosurgery can be performed on an outpatient basis. In some cases, the patient may be hospitalized after the procedure for observation.

A typical schedule for the day might be:

• 6:00-8:00 AM: The patient arrives at DHMC's Lebanon campus. Using a local anesthetic, the neurosurgeon applies a stereotactic frame to guide the subsequent treatment.
• 8:00-9:00 AM: The patient undergoes computed tomography (CY) or angiography.
• 9:00-11:00 AM: The radiation oncologist, the neurosurgeon, and the physics section utilize a treatment planning computer to simulate different treatment approaches involving a variety of radiation dose distributions and delivery angles to determine optimal treatment.
• 11:00 AM - NOON: The physics section verifies the treatment plan and checks the accuracy of the equipment set-up.
• NOON - 2:00 PM: The patient undergoes treatment. Using multiple arcing X-ray beams, the radiation from the linear accelerator is concentrated on the lesion. Adjacent tissue is spared.
• 2:00 PM: The frame is removed and the patient leaves after receiving post-treatment instructions.

The Norris Cotton Cancer Center is New Hampshire's only academic medical center. Its components are the Dartmouth Medical School (DMS), founded in 1797, which has an enrollment of 319 medical students and a core faculty of 200; The Hitchcock Clinic, the ninth-largest multi specialty group practice in the United States, with more than 350 physician members and associates who hold faculty appointments at DMS; the 429-bed Mary Hitchcock Memorial Hospital, a tertiary care facility for northern New England and the teaching hospital for DMS; the Matthew Thornton Health Plan, New Hampshire's oldest and largest managed health care organization; and the 224-bed Veterans Affairs Hospital in White River Junction, Vermont.