Synergy S is a linear accelerator that delivers stereotactic body radiosurgery. By combining imaging and radiation delivery in a single system, Synergy S® offers unsurpassed accuracy for treatment of tumors, lesions and malformations throughout the body as well as sites in the brain that are not accessible with the Gamma Knife®.

The Synergy S® combines a linear accelerator with an integrated 3D volume imaging system that allows clinicians to visualize the target at the actual time of treatment. Necessary adjustments can be made in the patient's position to ensure that the radiation is directed precisely at the tumor or lesion. Since the radiation dose is precisely targeted, there is less damage to the surrounding healthy tissue. Therefore, many patients who are no longer able to be treated by other methods may be candidates for treatment with the Synergy S®.

This procedure is normally performed on an outpatient basis and patients generally are able to continue their normal activities.

Synergy S - wide

Understanding the Terminology

Linear Accelerators are machines that produce and deliver radiation with exceptional precision.

Radiation Therapy refers to the treatment of cancer with radiation, generally from an external source. In conventional radiation therapy, larger areas of tissue are exposed to relatively larger fields of radiation over a number of sessions. Although the radiation affects both cancer and normal cells, it has a greater effect on the cancer cells.

Stereotactic Radiosurgery is a non-invasive procedure that delivers high-dose radiation to a tumor in a very precise manner. Despite its name, it is considered a form of radiation therapy, not a surgical procedure. Radiosurgery is called "surgery" because it delivers the radiation therapy with surgical precision. It combines the principles of 3D target localization with multiple intersecting radiation beams to precisely treat tumors. It allows for therapeutic doses necessary to destroy tumors while minimizing risk to surrounding sensitive or critical structures.

Synergy SConditions Treatable with Synergy S Technology


What to Expect At Your Synergy S Treatment Appointments

First Visit: Consultation
You will meet with the Radiation Oncologist who will review your medical history, medical records and any available x-rays or other diagnostic information.

Once Synergy S treatment is selected for your medical condition, you will be scheduled for your second visit, a two-part appointment to begin your treatment planning. The first part will focus on creating a custom body mold/immobilization device, an essential part of the highly precise radiation delivery associated with the Synergy S. The second part of the appointment will involve CT guided simulation.

If you need to have blood work done, you will be given a prescription and must have your blood work done PRIOR to your second visit.

Synergy S - treatment planningSecond Visit: Treatment Planning
When you arrive for your treatment planning, please bring:

  • a picture ID
  • your insurance card

Again, there are two appointments for treatment planning. The first appointment is to have the body mold/immobilization device made and the second appointment is the CT simulation. These two appointments will take place on the same day.

On the day of your appointments for treatment planning, you will first come to the Riverside and University of Virginia Radiosurgery Center, Entrance E. A radiation therapist will meet with you and take you into a room to create the custom body mold/immobilization device and/or an aquaplast mask. These devices are designed to assure that you are in the same position during your CT simulation as well as each of your treatments. This process usually takes between 30 to 45 minutes.

After the custom body mold/immobilization device is completed, the radiation therapist will walk with you to the CT department to perform the second appointment for CT simulation. You will have the CT simulation with a CT scanner using your custom body mold/immobilization device. The purpose of the CT simulation is to pinpoint the area of your body where the actual radiation will be aimed.

The radiation therapist will put some marks on your skin and you may receive small permanent marks called tattoos. These tattoo marks are used to help align your body for treatments. Photographs may be taken at this time to document your position for reference during your treatments.

 *You may receive an automated phone call from the hospital reminding you of your CT simulation appointment time. This notification is for your second appointment only. You are still to arrive at the Riverside and University of Virginia Radiosurgery Center, Entrance E, for your first of your two scheduled appointments for that day.

Synergy S - developing the planDeveloping the Treatment Plan
After the custom body mold/immobilization and CT simulation have been completed, the radiosurgery team of radiation oncologists and medical physicists will develop your personalized treatment plan using the images from the CT simulation.

Developing the treatment plan is an extremely vital and time-intensive part of your overall treatment. This important effort involves a multidisciplinary team and can take several weeks to complete. After the treatment planning phase is completed, you will receive a phone call with the date of your next appointment which is the dry run. You will also receive appointment dates for your actual Synergy S treatments.

Third Visit: The Dry Run
When you arrive at the RadiosurgeryCenter for this appointment, the radiation therapist will meet with you to explain the process and will take you to the treatment room. Next, you will lie on the treatment table in the same position as in the CT simulation. The radiation therapist will align your body using your custom body mold/ immobilization device and the marks or small tattoo on your skin. Multiple CT scans will be taken on the treatment machine to verify your position. From these images, any necessary adjustments will be made once they are compared to the initial images from the CT simulation visit. The radiation therapist will take measurements and adjust the Synergy S linear accelerator to verify your treatment plan. This will be a dry run or test run. You will not receive a treatment at this visit. This essential part of the treatment process usually takes between 30 to 45 minutes.

Synergy S - treatmentSynergy S Treatments
All of your treatment appointments will be at the Riverside and University of Virginia Radiosurgery Center, Entrance E. In most cases, you will receive a treatment, usually once a week, for two to five weeks depending on your specific treatment plan. During the treatment you will lie on theSynergy S® treatment table in the same position as in the CT simulation and dry run. Again, multiple CT scans will be taken on the treatment machine to verify your position. It is absolutely essential that you hold completely still during the scans as well as the treatment. After the verification scans, your treatment will begin. You will not feel or see anything during the treatment but you will hear a slight buzzing sound.

If needed, you may be given a prescription for a light sedative to take prior to each treatment. This mild medication can help you to relax and eliminate movement in the treatment position. If you do take the mild sedative, you must have someone drive you to and from each treatment.

At the end of your treatments, you will receive instructions on follow-up care. Approximately six to eight weeks after your last treatment you will have a follow-up appointment with either your referring physician or the radiation oncologist at the RadiosurgeryCenter. Prior to this follow-up appointment, your physician may request for you to have an imaging study, such as a CT, MRI, or PET scan, to evaluate your response to the Synergy S treatment.

Where Can I Find More Information?
Ask your physician about Synergy S treatment and whether or not it is appropriate for your condition and diagnosis. In addition, you can contact patient organizations and review web sites which are relevant to your diagnosis. You can also get more information by calling the Riverside and University of Virginia Radiosurgery Center at (757) 534-5220.