Contributed by: Dr Looi Wen Shen, Dr Wong Ru Xin, Dr Shaun Ho

Stereotactic Body Radiotherapy (SBRT) In Singapore

What is Stereotactic Body Radiotherapy (SBRT)?

Stereotactic body radiotherapy (SBRT) is a type of radiation therapy that uses highly focused x-ray beams to target tumours anywhere in the body. Stereotactic body radiotherapy can ablate and kill tumours without the need for surgery. SBRT can be used to treat tumours anywhere in the body including the prostate, lungs, spine, liver, neck, and brain. When used on the brain, it is often called stereotactic radiosurgery (SRS).

Common Cancer Types

• Prostate cancer
• Lung cancer
• Brain tumours or cancer
• Spine tumours and metastases
• Liver cancer
• Breast cancer
• Kidney Cancer

Advanced Imaging For SBRT

SBRT uses specialised imaging techniques to localise tumours to prepare for focusing radiotherapy beams on them to allow the least amount of damage to the healthy tissues around the area. At Singapore Advanced Medicine, we utilise our full suite of imaging techniques to help guide treatment including magnetic resonance imaging (MRI) and positron emission tomography (PET). Our radiotherapy machines are equipped with on-board CT imaging to help guide the treament.

How does stereotactic body radiotherapy (SBRT) work?

Similar to other types of radiotherapy, SBRT damages DNA inside the tumour cells. The damage kills the cells or causes them to be unable to make more cells, effectively destroying them. Usually 1 to 5 sessions are required.

Types of stereotactic body radiotherapy (SBRT)

Types include:

• Linear accelerator, e.g. Halcyon. These machines use X-rays to treat tumours and are the standard delivery system for SBRT.
• Proton therapy or Proton Beam Therapy. This is known as Stereotactic Body Proton Therapy (SBPT)
  • Only centres equipped with proton therapy can offer this. This is available in Proton Therapy SG at Singapore Advanced Medicine for multiple sites including brain cancer, prostate cancer and liver cancer.

How to prepare yourself for Stereotactic Body Radiotherapy (SBRT)

Firstly, a consultation is required. Please make an appointment here. The preparation depends on the area of the body treated and can range from no preparation at all to fasting for 2 to 3 hours. You might be asked to remove items such as jewellery, glasses, and dentures.

Importantly, let us know if you have medical devices such as a pacemaker, artificial heart valve, aneurysm clips, neurostimulators or stents inside your body.

What you can expect for Stereotactic Body Radiotherapy (SBRT)

SBRT is an outpatient procedure with no requirement for a hospital stay. Each treatment at Proton Therapy SG, Singapore Advanced Medicine is completed in about half an hour given the speed of delivery on our platform. You do not need to be accompanied by a caregiver in most situations.

Delivery of Stereotactic Body Radiotherapy (SBRT)

• Position– you must remain still.
• Marking– Small markers such as tattoos or fiducials might be required to mark out the position of the tumour
• Imaging– on-board imaging helps to verify the position
• Planning– the beam angles are planned in the days before delivery

Results

It is a little known fact that Stereotactic Body Radiotherapy (SBRT) has been demonstrated to prolong survival for cancer patients in certain situations such as oligometastatic disease (limited stage 4 metastatic cancer). Importantly, no detrimental impact on quality of life has been shown.

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