Quality and safety in stereotactic radiosurgery and stereotactic body radiation therapy: can more be done?

Stereotactic radiosurgery (SRS) has been an effective modality for the treatment of benign and malignant cranial disease for 50 years. Increasingly, the stereotactic approach, ablative doses of radiation delivered in a highly focused manner to a target of interest, is being applied in a number of extracranial disease sites. Stereotactic body radiation therapy (SBRT) holds significant potential for improving tumor control rates across a range of locations and histologies. Both SRS and SBRT require specialized technology, meticulous procedures, and dedicated personnel. Several recent high-profile medical radiation events have generated considerable attention within the media, and serve to remind the profession that close attention to ongoing quality improvement is a fundamental responsibility. The purpose of this manuscript is to provide some recommendations for SRS / SBRT processes and procedures that may be beneficial in understanding and reducing risks inherent to the modalities.