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Upright radiation therapy systems: Requirements, performance and benefits
Benjamin P Ziemer1, Dante P I Capaldi2
1Department of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA.
Journal of Radiosurgery and SBRT
|April 20, 2026
Summary
Upright radiotherapy, including stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT), offers improved patient comfort and accessibility. Technological advances now enable precise and effective upright treatments, overcoming previous limitations.
Area of Science:
- Radiation Oncology
- Medical Physics
- Patient Care
Background:
- Historically explored, upright radiotherapy is gaining traction for stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT).
- Conventional supine/prone positioning has limitations, particularly for certain patient groups.
Purpose of the Study:
- To explore the technological advancements, clinical implications, and adoption steps for upright radiotherapy.
- To highlight the potential of upright SRS/SBRT to improve patient comfort, accessibility, and treatment efficacy.
Main Methods:
- Review of technological advancements in patient simulation, immobilization, image guidance, and treatment planning for upright delivery.
- Assessment of recent developments in upright imaging systems and specialized positioning equipment.
- Analysis of studies demonstrating accuracy and feasibility of upright SRS/SBRT.
Main Results:
- Technological progress in imaging, immobilization, and planning supports safe and effective upright SRS/SBRT.
- Upright positioning achieves sub-millimeter accuracy comparable to supine techniques.
- Economic benefits include reduced infrastructure costs and potential for compact centers.
Conclusions:
- Upright radiotherapy, supported by technological innovation, is a viable and potentially advantageous approach for SRS/SBRT.
- Addressing imaging system limitations and further research will facilitate widespread adoption.
- Upright SRS/SBRT can expand treatment accessibility while maintaining high precision and efficacy.
