Side-effects of stereotactic radiotherapy

Stereotactic radiotherapy treatments generally have fewer side-effects than conventional radiotherapy, as less healthy brain tissue is affected and a lower dose of radiation is used.

Short term side-effects

It is very common to feel tired for a few days after stereotactic radiotherapy (SRT). Make sure you let yourself rest. 

Some people experience feelings of nausea, dizziness or faintness directly afterwards. However, this is uncommon as these side-effects are caused by swelling of the brain and doctors often give steroids before or immediately after your treatment to help prevent this.

If your treatment involved a head frame, the areas where the frame was attached to your skull may be tender and may bleed slightly or be slightly itchy as they heal. Your health team will give you information about keeping these clean to reduce the risk of infection at the pin sites.

You may also have a dull headache once the anaesthetic wears off. This can be eased with painkillers.

These side effects are generally short-lived but if you experience any side-effects, particularly ones that you’re concerned about, speak to your doctor.

If your tumour was near the surface of your skull, you may lose some hair, but hair loss is rarely a side-effect of SRT treatments.

There is also a slight possibility that you may have a seizure after stereotactic radiosurgery (SRS). This is more likely in people who have had seizures before the treatment. Although seizures are rare, the DVLA or DVA in Northern Ireland does not allow you to drive for at least one month after your treatment, even if you have not had seizures previously.

It is also important to be aware that radiotherapy of any type can cause swelling in the tissue around the treated area. This can make it look like the tumour is growing again on a post treatment MRI scan. This is known as pseudo-progression and can make it difficult to assess the effect of the radiotherapy for a period of time after treatment.

Long term side-effects

As SRT treatments involve a very high dose of radiation, some people can develop a section of dead cells in the treated area known as ‘radiation necrosis.’

This can happen from months to decades after treatment, but it generally occurs six months to two years after the SRT procedure. It is more likely if you have chemotherapy as part of your treatment.

Most people who develop radiation necrosis will have no symptoms as the area will be very small. If symptoms occur due to swelling steroids can be given to treat this. Occasionally, however, surgery may be required to remove the dead tissue.

If you have any concerns, discuss them with your health team.