Information for patients having stereotactic radiotherapy for benign and malignant brain conditions
Date issued: October 2026
Review date: October 2028
Leaflet section: Oncology
Stereotactic Radiosurgery - Southwest Peninsula Service
Please DO NOT drive on the day of your treatment. You are advised to have someone to stay with you overnight on your treatment day
Introduction
This booklet explains what to expect if you are having stereotactic radiotherapy, also called SRS or SRT. It describes how your treatment is planned and delivered, possible side effects, and who to contact if you have concerns.
Your treatment will be planned for your individual condition. The medical team will discuss the expected benefits, possible risks and alternative treatments with you. Please ask questions if anything is unclear or if you have any worries.
The decision to proceed with treatment will be made jointly by you and your consultant. This booklet provides general information and does not replace the discussion with your treatment team.
What is Stereotactic Radiotherapy?
Stereotactic radiotherapy is a highly accurate form of radiotherapy used to treat small, well-defined areas in the brain. It may be used for some benign or malignant tumours and other brain conditions.
Your treatment is planned using detailed CT and MRI scans. A close-fitting mask helps to keep your head still and allows the treatment to be delivered accurately. The radiotherapy machine delivers several carefully shaped beams from different directions. The beams meet at the treatment area, giving a high dose to the target while limiting the dose to the surrounding healthy brain tissue.
Stereotactic radiotherapy may be given as:
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Stereotactic radiosurgery (SRS): usually delivered as a single treatment.
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Fractionated stereotactic radiotherapy (SRT): delivered over several treatments, or fractions.
Although the term “radiosurgery” is used, SRS does not involve an operation or surgical incision.
Plymouth Oncology Centre has provided stereotactic radiotherapy since 2005. Your suitability for this treatment will be assessed by the specialist team, and the recommended treatment will depend on your diagnosis, the size and location of the target, your general health and previous treatments.
How does the radiotherapy work?
Radiotherapy works by damaging tumour cells and stopping them growing. With slowly growing benign tumours, the radiation may stop the growth or make the tumour shrink (sometimes the tumour may grow a little in the first few months). In malignant tumours, the aim is to shrink the tumour.
The head is positioned in a mask, and the exact location of any lesion (target) can be accurately found by the computer controls. A beam of radiation is shaped and aimed at the target. Beams can be directed from many angles, if necessary, to minimise the dose of radiation to normal brain but maximise the dose to the target.
After radiotherapy, scans are repeated at regular intervals to monitor your tumour/s.
Treatment Planning
Your case will be discussed by a specialist multidisciplinary team (MDT). This team may include clinical and medical oncologists, neurosurgeons, neuroradiologists, radiographers, physicists and other healthcare professionals with expertise in stereotactic radiotherapy.
The team will review your diagnosis, scans, previous treatment, general health and the size and position of the area to be treated. They consider whether stereotactic radiotherapy is suitable for you, whether another treatment would be more appropriate, and whether you will need one treatment or several treatments.
Your consultant will discuss the expected benefits, possible risks and alternative treatments with you. You will have the opportunity to ask questions before deciding whether to proceed.
Detailed CT and MRI scans may be used to create your individual treatment plan. The scans allow the treatment team to identify the target and the nearby structures that need to be protected. Your treatment plan will be checked and approved before treatment is given.
We may discuss your case with specialists at another radiosurgery centre if this would help us plan your care. If treatment at another centre is recommended, we will explain the reasons and the arrangements to you.
We will contact you when your treatment plan is ready and confirm your treatment date and appointments. Relevant information about your treatment will be sent to your GP and other members of your care team.
The steps of treatment
1. Initial appointment
We will contact you by telephone or letter to confirm the date of your initial appointment and explain what you need to do before attending.
2. Making your mask and planning scans
You will attend the Mould Room in Oncology Level 2, to have a close-fitting stereotactic mask made. The mask is shaped to fit your head and helps you keep still during the scans and treatment.
This appointment usually takes about two hours. A planning CT scan will be performed while you are wearing the mask. You may also need an MRI scan at Derriford Hospital. If you need an injection of contrast for a scan, we will explain this to you beforehand.
3. Preparing your treatment plan
Your CT and MRI scans will be used to create your individual treatment plan. The treatment team will identify the target and plan the radiation beams while limiting the dose to nearby healthy tissue.
Your plan will be checked and approved before treatment. Planning usually takes around two weeks after the relevant scans have been completed, although this may take longer for more complex treatments.
4. Confirming your appointments
When your treatment plan is ready, a member of the radiotherapy team will contact you to confirm your treatment date and appointments.
Before treatment, a radiographer will speak to you by telephone to explain what will happen and answer any questions. You will be given a list of your appointments.
5. Treatment
On the day of treatment, you will lie on the treatment couch and wear your stereotactic mask. The radiographers will position you carefully and take images to check that you are in the correct position.
The treatment itself usually takes about 30-40 minutes. More complex treatments may take longer. The whole appointment may take longer than this because of preparation, positioning and safety checks.
You will be aware of the couch moving or tilting and the treatment machine moving around you. The radiographers will be able to see and hear you throughout the treatment. If you become uncomfortable or worried, tell the radiographers; they will stop and help you if necessary.
6. After treatment
You can usually leave hospital when the radiotherapy team is satisfied that you are well enough to go home. You should arrange for someone to take you home and should not drive yourself after treatment. Please follow the advice in the section “Am I allowed to drive?”
You do not need to bring special clothing or equipment. Please remove jewellery and leave valuables at home. You may bring a friend or relative with you, but they will need to leave the room during scans and treatment.
Am I allowed to drive?
Do not drive yourself to or from your treatment appointment. You may feel tired, dizzy or unwell after treatment, and you should arrange for somebody to take you home. You should not drive if you feel unfit, including if you have dizziness, drowsiness, visual problems, weakness, poor balance or difficulty concentrating.
Whether you can drive between treatments, or after completing treatment, depends on your diagnosis, symptoms, risk of seizures, medication and the type and location of the condition being treated. Your clinical team will advise you when it is safe to resume driving, but you remain responsible for ensuring that you are medically fit to drive.
If you have been diagnosed with a brain tumour or another condition that may affect driving, you may need to tell the Driver and Vehicle Licensing Agency (DVLA). Please check the current DVLA guidance on a brain tumour and driving and inform your motor insurer of any relevant medical condition. Do not wait for DVLA’s decision before stopping driving if your clinical team has advised you not to drive.
You must not drive yourself if you have been advised to stop driving.
For hospital transport for patients whose medical condition or mobility issues prevent them from using standard transport, please telephone
0345 155 1009 (Devon patients) or
01872 252211(Cornwall patients).
There may be local volunteer car services in your area.
Staying nearby
Should you wish to stay in the Derriford Hospital area before or after your treatment the following accommodation is available a short walking distance from the hospital at a reasonable charge
Hearts Together
7 Blunts Lane
Derriford
PL6 8BE
Tel: 01752 315900
Email: bookingenquiries@heartstogether.org.uk
There are also hotels in the close vicinity of the hospital.
What side effects can I expect?
Stereotactic radiotherapy is not painful. You will need to lie still while wearing your mask, and you may notice the treatment couch moving or tilting and the treatment machine moving around you.
Many people have few or no immediate side effects. Some people experience tiredness, headache, nausea, vomiting, dizziness or feeling unsteady during treatment or shortly afterwards. These symptoms may be caused by temporary swelling around the treated area of the brain. Your doctor may prescribe medicines, such as steroids or anti-sickness medication, if needed.
The possible side effects depend on the condition being treated, the size and location of the treatment area, the dose and number of treatments, and any previous treatment. Not all the effects listed below will apply to you.
Possible side effects include:
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a small area of temporary hair loss or scalp changes
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worsening of symptoms caused by the condition being treated
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seizures or a change in seizure control
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changes in balance, coordination, hearing, vision or sensation
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changes in memory, concentration or thinking
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bleeding around the treated area or a build-up of fluid in the brain, which are uncommon but may require further treatment.
Some side effects can develop months or years after treatment. These may include persistent or permanent hair thinning, seizures, changes in memory or concentration, or changes related to the part of the brain treated.
A small area of treatment-related tissue injury, called radionecrosis, may develop in the treated area. This may be seen only on a scan or may cause symptoms. It can sometimes require treatment with steroids or, rarely, surgery.
The risks for certain conditions may be more specific. For example, treatment near the hearing, balance, vision or pituitary areas may affect those functions. Your clinical team will explain which risks are relevant to you.
Individual consent
This section provides general information and does not replace individual consent. At your new patient appointment, you and your clinician will have a full and detailed discussion about:
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the aim of treatment
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the expected benefits
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alternative treatments, including no treatment
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the possible side effects and risks relevant to you; and
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the likelihood and possible severity of these side effects.
You will have the opportunity to ask questions before deciding whether to proceed.
Your consent will be confirmed again at the appointment when your mask is made, and your planning scan is performed. This is an opportunity to check that you remain happy to proceed and that there have been no changes to your health, treatment plan or circumstances. Please tell a member of the team if you have any new concerns or would like further information.
When to seek help
Please contact the SRS Clinical team by the contact numbers below, if you develop new or worsening symptoms after treatment, particularly:
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a severe or worsening headache
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repeated vomiting;
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increasing drowsiness or confusion
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new weakness or numbness
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difficulty speaking
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changes in vision or a seizure.
Call 999 if someone has a prolonged seizure, loses consciousness, or does not recover normally after a seizure.
Acoustic neuroma
People treated for an acoustic neuroma, also called a vestibular schwannoma, may develop delayed symptoms several months after treatment. These can include headache, nausea, dizziness or worsening balance. This may be caused by temporary swelling around the treated area.
Please contact the SRS clinical team if you develop new or worsening symptoms. Depending on your symptoms, we may recommend treatment such as steroids, anti-sickness medication or vestibular rehabilitation and balance exercises. Your clinician will discuss the risks that are specifically relevant to treatment of your acoustic neuroma.
Hair loss and scalp changes
You may lose a small amount of hair in or near the treatment area. This usually starts a few weeks after treatment and is generally temporary, with regrowth often beginning within a few months. In some patients, hair regrowth may be slower, patchy or, rarely, permanent. The treated area of scalp may become dry, red or discoloured, itchy or tender. Wash your hair gently with lukewarm water and a mild, unperfumed shampoo, and pat the area dry rather than rubbing it. Avoid hot hairdryers and other sources of heat; if you use a hairdryer, use the cool setting. Protect your scalp from direct sunlight with a hat or other covering and follow the radiotherapy team’s advice about sunscreen.
Follow-up
The stereotactic clinical nurse specialist will call you 2 weeks after your treatment has finished to ask how you are. Ongoing follow up will be done by regular MRI imaging at suitable intervals.
If you have any concerns about your side effects, please contact the team on the contact numbers listed below.
Glossary
SRT- stereotactic radiotherapy (fractionated i.e. many treatments)
Lesion or tumour - any abnormality seen on a brain scan requiring treatment.
Benign - not cancerous growth
Fractionated- several treatments as decided by the doctors for medical reasons.
Malignant - harmful cancerous cells which invade normal tissue.
Radiotherapy - use of radiation (special x-rays) to destroy normal or abnormal cells.
Computerised Tomography (CT) - a form of x-ray imaging when sections of a patient’s body are reconstructed to help with diagnosis/treatment planning.
Head mask - this keeps the patient’s head fixed for procedures and can be used to localise the correct target.
Linac - Linear Accelerator. A special x-ray machine used to produce radiation for treatment.
Magnetic Resonance imaging (MRI) - An alternative method used to image the head.
Multidisciplinary (MDT) - all members of the specialist team. This includes radiation oncologists, neurosurgeons and radiologists.
Members of the Southwest Team
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SRS Nurse Specialist (CNS). Available for you to contact for advice and support before and after treatment.
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Neurosurgeon. Surgical treatment of patients with brain tumours including acoustic neuromas and meningiomas.
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Consultant Clinical Oncologist. Leads on radiotherapy for malignant and benign tumours.
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Oncology Specialist Doctor. Works directly with the lead Clinical Oncologist
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Neuro Radiologist. Reports on the scans and helps the Consultant define the area to be treated.
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SRS Physicist/ Clinical Scientist. Responsible for radiosurgery treatment planning and ensures that the QA for treatment plan is correct.
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SRS Dosimetrist. Responsible for radiosurgery treatment planning.
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Lead STARS Radiographer. Leads the SRS treatment team.
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Radiotherapy Manager. Manager of the Radiotherapy service
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SRS administrators. Responsible for booking pre-treatment appts, admin enquiries and SRS MDT.
Contact telephone numbers
Clinical enquiries:
Specialist CNS for SRS (Monday, Wednesday and Thursday) 01752 431521
Neuro-oncology CNS* (Tuesday or Friday) 01752 431210
*If unable to contact SRS CNS (see below)
Clinical enquiries about your treatment or side effects should be directed to the SRS CNS on Monday, Wednesday and Thursday or to the Neuro-oncology CNS team on Tuesday or Friday for urgent clinical enquiries only.
Admin and appointment enquiries:
SRS Admin Team 01752 439272
Radiotherapy Treatment team appointments office 01752 431870
Out of hours/urgent clinical contact:
Brent ward 01752 430043
Acute oncology team 01752 202082 - ask for bleep number 0023
Please ring NHS 111 if you have a problem out of normal hours (9am to 5pm).
For enquiries about cancer treatment or disease outside the brain, please contact your local oncology team.
Please leave a message on the answerphone and the team will get back to you as soon as possible.
Additional support
For patients with a cancer diagnosis, there is a variety of support available at the local cancer support centres near you.
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The Mustard Tree, Derriford Hospital Plymouth: 01752 430060
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The Cove, Royal Cornwall Hospital, Treliske, Truro: 01872 256363
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The Lodge Cancer Support and Information Centre Torbay Hospital: 01803 656490
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The Force cancer charity at Royal Devon and Exeter Hospital: 01392 406151
National support
The Brain Tumour Charity offers information and support for people affected by brain tumours and their families.
Helpline: 0808 800 0004
Personalised support for people living with a brain tumour and their loved ones.
Helpline: 01983 292 405
Macmillan Support Line
Confidential support to people living with cancer and their loved ones.
Helpline: 0808 808 00 00
Website: Macmillan Cancer Support
Other formats
If you need this leaflet in another format such as Braille, large print, high contrast, British Sign Language or translated into another language, contact the Patient Advice and Liaison Service (PALS):
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01752 439694
