TREMOR

This study is a trial of frameless linac-based stereotactic radiosurgical thalamotomy using coordinate-based targeting of the ventral intermediate (VIM) nucleus. All participants will receive 130Gy to be delivered to Dmax utilising a 4mm tertiary conical collimator. This dose will be delivered in a single fraction (i.e. one treatment session) for most participants, but if participants are not able to complete the treatment in one session and have received less than 110Gy they will have the opportunity to receive the remaining radiation dose no later than the next day. The treatment will take approximately 1 hour.

Prior to treatment, participants will undergo a planning MRI and planning CT scan. Treatment will be planned and delivered at Icon Cancer Centre Richmond by a qualified investigator and radiation therapy team.

A number of quality assurance measures are in place to ensure all treatment plans are reviewed and approved by the appropriate parties (e.g. medical physicist) to ensure safety and accuracy. Post-treatment, imaging is taken and reviewed by radiation therapists to check the treatment delivery. All reviews will be documented in the medical record.