Precision Radiation Therapy Advances Offer Novel Hope for Brain Metastases Patients
The Centre de Radiothérapie d’Oncologie Médicale de la Garonne (CROMG) – Amethyst Radiothérapie in Agen, France, has begun offering stereotactic intracranial irradiation since the spring of 2025, a cutting-edge technique for treating brain metastases. This advancement eliminates the need for patients to travel to larger cities like Bordeaux or Toulouse for specialized care.
What is Stereotactic Radiotherapy?
Stereotactic radiotherapy delivers high doses of radiation to very small volumes within the patient’s body, concentrating the radiation on the malignant lesion. This precision is achieved through a significant investment of nearly 3 million euros in a new generation radiotherapy machine installed at CROMG in November of last year.
“This investment reflects our commitment to anticipating future needs and providing treatments that are increasingly precise, effective, and respectful of patients’ quality of life,” says Nayef Idrissi, Director of Operations at Amethyst Radiothérapie France in Agen.
A Networked Approach to Innovation
The CROMG’s ability to offer this advanced treatment is also attributed to its partnership with a European network of radiotherapy clinics. This collaboration facilitates resource sharing and the acquisition of innovative equipment, according to Dr. Galaad Bernard-Faure, a radiation oncologist at CROMG.
Protecting Healthy Tissue with Targeted Radiation
Traditionally, whole-brain irradiation was the standard treatment for brain metastases. However, stereotactic radiotherapy allows clinicians to target only the lesions, delivering high doses to a localized area. “Stereotactic intracranial irradiation allows us to treat metastases in a highly targeted manner, and also consider retreatment if new lesions appear during follow-up. We are focused on controlling the disease over time, while preserving as much healthy brain tissue as possible,” explains Dr. Bernard-Faure.
Brain metastases are often linked to primary cancers of the lung, breast, melanoma, and certain digestive and kidney cancers.
Technology Behind the Precision
The CROMG utilizes HyperArc technology (Varian) to optimize treatment planning and treat multiple metastases in a single session. The ExacTrac Dynamic (Brainlab) system ensures continuous monitoring of the patient’s position, using a head-immobilizing mask. By combining imaging and dynamic motion tracking, real-time corrections are made, guaranteeing submillimeter precision throughout the irradiation process.
Reducing Patient Travel and Treatment Time
Aurore Labrot, a radiotherapy technician and stereotaxy specialist, highlights the benefits for patients: “Before this local implementation, patients had to travel to Toulouse or Bordeaux, which involved tiring journeys. A major benefit is therefore proximity, but also the fact that the treatment involves few sessions: 3 sessions in total, sometimes 5, spaced 24 hours apart.”
The technique delivers a dose of 9 Gray per session, compared to 2 Gray in conventional radiotherapy. “It aims at the millimeter,” emphasizes Labrot, noting that everything is meticulously monitored before and after treatment with radio and scans, validated by a physician, and closely supervised during the session. “Healthy tissues are particularly protected.” Chemotherapy is temporarily suspended.
Limitations and Future Applications
Dr. Bernard-Faure notes that stereotactic radiotherapy is most effective for lesions under 5 cm in size. Smaller lesions also present challenges, requiring a minimum size of 3-4 millimeters for accurate positioning and treatment. “Local control is excellent. We can often eliminate the disease in the treated brain area, even if a scar may persist on MRI.” The treatment can be repeated as long as the number of metastases remains limited. However, in cases of widespread metastases, whole-brain irradiation may be preferred.
The CROMG’s investment provides patients in Lot-et-Garonne and the Gers region with local access to advanced radiotherapy, avoiding lengthy travel for a 20-minute treatment session.
Expanding Capabilities: Lung and Prostate Metastases on the Horizon
Currently, the center treats intracranial metastases, with plans to expand to pulmonary and prostate metastases by the end of 2026. Regarding primary brain tumors, Dr. Bernard-Faure explains that these are typically treated with standard methods – systemic chemotherapy combined with conventional radiotherapy – but stereotaxy can be used to treat very localized recurrences.
Benign brain tumors that are aggressive or cause cognitive impairment or compression may also be eligible for treatment. Treatment decisions are made collaboratively in multidisciplinary meetings to determine the most appropriate protocol.
FAQ
Q: What are brain metastases?
A: These are cancers that have spread to the brain from another part of the body.
Q: How does stereotactic radiotherapy differ from traditional radiotherapy?
A: Stereotactic radiotherapy delivers a higher dose of radiation to a smaller, more precisely targeted area.
Q: How many treatment sessions are typically required?
A: Typically, 3 to 5 sessions are needed, spaced 24 hours apart.
Q: Is this treatment available to all patients with brain metastases?
A: The suitability of this treatment depends on the size, number, and location of the metastases.
Q: Where is CROMG located?
A: CROMG is located in Agen, France.
Did you know? The CROMG was formerly known as Calabet.
Pro Tip: Early detection and diagnosis are crucial for successful cancer treatment. Consult with your doctor if you experience any concerning symptoms.
Learn more about cancer treatment options at CROMG and Amethyst Healthcare.
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