Patient Experience Improves With Open Mask Frameless Stereotactic Radiosurgery

Undergoing stereotactic radiosurgery (SRS) to treat a brain tumor can be daunting enough, without the added stress of wearing a head frame attached to your skull with pins. Thankfully, patients at Smilow Cancer Care Center in Greenwich now have access to open mask frameless SRS.

Joining Emilie Nanne, RT, (center) holding the open mask, are (l-r) Samuel Cotte, RT, Bruce McGibbon, MD, director of Radiation Oncology, Carolyn Troy, RN, and Alexander Pevsner, physicist, at the Smilow Cancer Hospital Care Center in Greenwich. Photo: Greenwich Hospital

“We create a custom-fitted, plastic mask that holds their head in place during treatment,” said Bruce McGibbon, MD, director of Radiation Oncology in a release. “Our advanced technology can directly target the radiation to tumors without using an immobilization frame, which greatly enhances the patient experience by increasing comfort and reducing stress. And the opening in the mask for the eyes and nose causes much less claustrophobia than classic masks.”

Stereotactic radiosurgery – which doesn’t involve surgery at all, despite the name – can deliver a single, high dose of radiation precisely to the tumors causing them to shrink or disappear. This technique means patients can avoid the risk of open skull brain surgery to kill or shrink tumors.

In traditional radiosurgery, patients wear a head frame attached to their skull with pins and fastened to the treatment table to keep their head perfectly still during imaging and treatment, thereby preventing the radiation beam from damaging healthy brain tissue. And because the planning session (simulation), treatment design process and actual treatment need to take place on the same day with the frame-based system, patients often wear the frame for hours. “This can be very upsetting for some patients,” said Dr. McGibbon.  

With the frameless system, simulation, planning and treatment occur on different days. During the simulation, the radiation team makes a mask that precisely conforms to the size and shape of the patient’s face and then does a CT in that position. On the day of treatment, patients are again immobilized with the mask and a cone-beam CT is done to verify alignment. Special surface-tracking technology monitors the patient in real-time to ensure that there’s no movement. The system automatically shuts off the beam if the targeted area moves out of range.

“This is one of the many ways we ensure treatment accuracy,” Dr. McGibbon said.