What is stereotactic radiosurgery?

Stereotactic radiosurgery, or SRS, is an advanced radiotherapy technique that precisely delivers multiple beams of radiation to a tumour, sometimes in one single treatment session. Despite its name, SRS is not surgery – it doesn’t involve any incisions and the procedure is painless.

SRS is often referred to as a ‘brain-sparing’ radiotherapy approach as it’s widely recognised for its ability to preserve the quality of life in people with cancers that have spread to the brain (brain metastases).

We offer SRS as part of our comprehensive state-of-the-art neuro-oncology service in Oxford and London. This also includes an array of advanced diagnostics and planning techniques that enable us to create your own tailored treatment plan. Our neuro-oncology service is underpinned by leading professionals and world-class technology so that we can offer exceptional care and maximise your chance of the best possible outcomes.

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If you’d like more information about our specialist stereotactic radiosurgery service, just get in touch.

SRS versus conventional brain radiotherapy

Conventional radiotherapy for the treatment of brain tumours involves high-energy X-ray beams that deliver a prescribed dose of radiation directly to your tumour cells. The aim is to shrink your tumour and stop it from growing. If you have several small tumours (metastases) the radiation is often directed across the whole brain area.

SRS uses narrower X-ray beams which are from different angles. As a result, SRS can target small tumours with exceptional accuracy while avoiding the surrounding healthy brain tissue. Because of this greater accuracy, we are able to deliver higher doses of radiation to the tumour site and minimise the side effects you’ll experience.

The three main advantages of stereotactic radiosurgery (SRS) over conventional radiotherapy are:

  1. Single treatment
    You may need as many as 10 treatments with conventional radiotherapy. But with SRS, the radiation is far more powerful and can be delivered in as little as a single dose, allowing you to get on with your day-to-day life.
  2. Reduced side effects
    Increased accuracy means the radiation beam is less likely to hit your healthy tissue – and so less likely to cause long-term side effects. Several studies have shown that this can help to preserve everyday cognitive function and an improved quality of life after treatment.
  3. Less likely to need conventional surgery
    In many cases, SRS can be used in place of conventional surgery. This means no invasive treatment, no scarring, a quicker recovery period and little risk of infection.

What happens during SRS?

SRS can be delivered using many different advanced technologies. We use a linear accelerator (linac) and X-ray radiation at our centres in Oxford and London. Our centre in London also has a Gamma Knife which uses gamma rays. Both these techniques are equally effective in treating brain metastases, but there are some differences in the planning and treatment for each.

Follow this link if you want more information about Gamma Knife radiosurgery at our GenesisCare Centre for Radiotherapy at Cromwell Hospital

Here’s what to expect during your SRS treatment plan in Oxford and London using a linear accelerator – including before, during and after the procedure.

Who is suitable for SRS?

SRS may be suitable for you if you have either a tumour that starts in your brain (primary tumour) or a tumour that has spread from elsewhere in your body (metastatic or secondary tumour). This includes:

  • If you’ve had surgery to remove brain metastases to reduce the risk of recurrence
  • Small tumours such as pituitary adenomas and chordomas or meningiomas at the base of the skull
  • Benign (non-cancerous) tumours such as acoustic neuromas (vestibular schwannomas)

SRS may not be suitable if:

  • The treatment area includes certain important nerves that could be damaged by radiation
  • Your tumour is larger than 3cm across

Our clinicians are experts in the use of SRS as well as other techniques and will decide if this is the best option for you after careful evaluation of your condition.

Possible side effects

Stereotactic radiotherapy is a well tolerated treatment with greater accuracy than conventional radiotherapy.

Not everyone experiences side effects but your risk may be affected by your general health, other treatments you’ve had and the location of your lesion or tumour.

If you do experience some changes after treatment, your care team will advise you on the best way to deal with them.


Our multidisciplinary team

We have specially selected a neuro-oncology multidisciplinary (MDT) team that brings together the expertise of neuro-radiologists and neuroimaging scientists, alongside neuro-oncologists and neurosurgeons. This dedicated team will review all referrals to our neuro-oncology service, meaning your care will be planned by a team of experts to ensure you get the best treatment tailored to your needs. The members of our neuro-oncology MDT are listed below.

Dr Meera Nandhabalan


Clinical Oncologist


Professor Puneet Plaha




Dr Natalie Voets




Dr Anup Vinayan


Clinical oncologist

London Cromwell Hospital +3

Dr Fintan Brian John Sheerin

MA hons Cantab Physiology MB, Bchir hons Cantab MRCP UK FRCR



Mr Richard Stacey

MBBS (London) FRCS, FRCS (surg. neurology)



Dr Pieter Michiel Pretorius

MBChB (University of the Free State) MSc (OXON) FRCR



Dr Luis Aznar-Garcia


Consultant Clinical Oncologist

Nottingham +2

Mr David Peterson

MB BS BSc FRCS FRCS (neurosurg)

Consultant Neurosurgeon

London Cromwell Hospital

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