Some newer ways of giving radiotherapy are being assessed to see whether they give better results than standard radiotherapy. Research studies are being carried out to see whether the new techniques can control the cancer better while causing fewer side effects. Some of the techniques are described below.

Many specialist hospitals now use a technique known as conformal radiotherapy. Conformal radiotherapy uses the same radiotherapy machine as normal radiotherapy treatment. However, a device called a multi-leaf collimator is used to arrange the beams to target the area of the cancer. This ensures that a higher dose of radiation is given to the tumour. Healthy surrounding cells and nearby structures receive a lower dose of radiation, so the possibility of side effects is reduced.

The multi-leaf collimator consists of a number of metal sheets which are fixed to the radiotherapy machine. Each sheet can be adjusted so that the radiotherapy beams can be shaped to the treatment area.

Precise positioning of the radiotherapy machine is very important for conformal radiotherapy treatment and a special scanning machine may be used to check the position of your internal organs at the beginning of each treatment.

High-resolution intensity-modulated radiotherapy, which is sometimes called three-dimensional IMRT (3D-IMRT) also uses a multi-leaf collimator. During this treatment the layers of the multi-leaf collimator are moved while the treatment is being given. This method is able to shape the treatment beams even more precisely and allows the dose of radiotherapy to be altered in different parts of the treatment area.

Research studies have shown that conformal radiotherapy and intensity-modulated radiotherapy have less side effects than traditional radiotherapy treatment. However, it is possible that by shaping the treatment area so precisely, microscopic cancer cells just outside the treatment area may not be destroyed. This means that the risk of the cancer coming back in the future could be higher with these specialised radiotherapy techniques. Research studies currently being carried out should show whether this is the case.

Stereotactic radiotherapy is used to treat brain tumours.

This technique directs the radiotherapy from many different angles so that the dose going to the tumour is very high and the dose affecting surrounding healthy tissue is very low. Before treatment, several scans are analysed by computers to ensure that the radiotherapy is precisely targeted, and the patient's head is held still in a specially-made frame while having the radiotherapy. Several doses are given.

This treatment is available only in some specialist hospitals and isn't suitable for all patients with brain tumours. Your clinical oncologist can discuss whether it may be appropriate in your case.

In fact, this type of radiotherapy, again for brain tumours, does not use a knife but very precisely targeted beams of gamma radiotherapy from hundreds of different angles. Only one session of radiotherapy, taking about four to five hours, is needed.

For this treatment you will have a specially-made metal frame attached to your head. Then several scans and x-rays are carried out to find the precise area where the treatment is needed. During the radiotherapy, you lie with your head in a large helmet, which has hundreds of holes in it to allow the radiotherapy beams through.

This treatment is available only in specialist hospitals and is not suitable for all patients with brain tumours. You can discuss with your clinical oncologist whether it may be appropriate for you.