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Welcome from Associate Professor Robert Smee - Prince of Wales Hospital

 Associate Professor Robert Smee

Welcome to a website that will take you through the progress and development of our Stereotactic Radiosurgery/Radiotherapy Clinical Program in Australia. To date this clinical unit at the Prince of Wales Hospital has been responsible for the treatment of more patients than any other in Australia, and the development of more advanced techniques.


The Stereotactic Radiosurgery Unit at The Prince of Wales Cancer Centre in Sydney introduced this specialised treatment to Australia in 1990, making this unit the most experienced facility of its type in Australasia.  Over 2,500 patients have been treated by Stereotactic Radiosurgery (SRS) to date.  Fractionated Stereotactic Radiotherapy (FSRT) has been available for the past 10 years with 1,200 patients treated within this time frame. In November 2000 this department became the first site in Australia to offer Intensity Modulated Radiation Therapy (IMRT). With these facilities the first person in the world to receive Stereotactic IMRT with a Mini-Multi Leaf Collimator (MMLC) was treated in this department.  Advanced computer programs are available and combined with our Quality Assurance Programs ensure accuracy and safety of the treatment delivery to every patient.

Many lesions or tumours in the brain are not suitable for treatment by surgery. Features that determine this include:

  • Site
  • Proximity to important brain structures such as the optic chiasm and brain stem
  • Previous treatment given
  • Patient preference for non surgical treatment.

Stereotactic radiation treatment relies upon precisely locating the lesion in the brain with exact coordinates (as with latitude and longitude), and aiming at this target. This treatment can be given as follows:


Stereotactic Radiosurgery- a single high dose of radiation is given, the procedure being done in one day, the great majority being treated as outpatients. This is suitable where the target (lesion) is less than 3cm in size, and away from important structures such as visual (optic) nerves.

Types of tumours suitable for Stereotactic Radiosurgery include:

Benign tumours:

Malignant tumours:

  • Arteriovenous Malformations
  • Meningiomas
  • Pituitary tumours
  • Vestibular Schwannomas/Acoustic Neuromas
  • Trigeminal Neuralgia
  • Glomus tumours
  • Cerebral metastases
  • Stereotactic Radiotherapy - this gives the radiation treatment over many days (fractions) ranging from 3-5Gy, to 30-70Gy, being treated 5 days per week. This procedure allows larger lesions (up to 5cm in size) and those close to important structures to be treated.

    Benign tumours:

    Malignant tumours:

    • Meningiomas
    • Pituitary tumours
    • Large Vestibular Schwannomas/Acoustic Neuromas
    • Craniopharyngiomas
  • Gliomas
  • Medulloblastoma boost
  • Chordomas