Gamma Knife
N.N. Burdenko Neurosurgical Institute improves treatment of patients with multiple metastases
Russia’s first Leksell Gamma Knife® Perfexion™ system has found a home at the renowned N.N. Burdenko Neurosurgical Institute, just a five-minute car ride from Moscow’s Red Square. On June 2, 2011, a 59-year-old woman was the first Perfexion patient, receiving Gamma Knife® radiosurgery to treat tumor tissue that remained following open surgery. Now, eight months later, the Institute has treated more than 400 patients on the system, half of them with one or more metastases, tumors for which Gamma Knife surgery is increasingly regarded as the preferred frontline treatment.
Gamma Knife surgery is a gentler alternative to traditional brain surgery for illnesses such as metastatic disease – cancer that has traveled to the brain from elsewhere in the body. The system precisely delivers up to thousands of low-intensity radiation beams to one or more targets in a single session.
Gamma Knife technology is not new to N.N. Burdenko clinicians – they had operated a Leksell Gamma Knife® C since 2005, treating a total of 1,812 patients, comprising 2,075 radiosurgery treatments over six years. Many of these patients received Gamma Knife surgery to treat multiple metastases, which often involved multiple treatment sessions or single sessions that could stretch to several hours.
“In the United States and European countries, there is some discussion about a threshold for the number of mets treated in a single session – three or four or more, but we’ve tried to treat all of them,” says Andrey Golanov, M.D., Ph.D., Chief of the Department of Radiotherapy and Radiosurgery. “The most we’ve treated with our previous Gamma Knife is 32 mets in one session, but of course that took many hours. In the past, however, many patients with multiple mets had deposits located in different parts of the brain or had radioresistant mets. Both types of cases have required more than one session. Leksell Gamma Knife Perfexion has completely changed our approach to multiple metastases – we no longer have any limitations.”
Perfexion dramatically streamlines the radiosurgery workflow and expands the treatable volume through an automated, multi-source collimator. The result has been faster set-up and treatment delivery to one or more tumors in a single session.
“Everything’s easier with Perfexion, and that makes it easier for both patients and staff,” Dr. Golanov says. “There’s the potential for more indications, it’s easier to plan and treat and the dose planning is superior with higher conformity. This is particularly evident in treating patients with multiple mets. For example, just yesterday we treated a patient with five metastases in only one hour – and these were large lesions requiring more than one beam per tumor.”
Perfexion and Elekta Infinity at top of customer rankings in report*
With a score of 94.4 out of 100, Elekta’s Leksell Gamma Knife® Perfexion™ is “practically perfect in every way,” ranking at the top among six advanced radiation therapy systems, according to KLAS research firm’s recently released customer survey, Radiation Therapy 2011: A Dose of New Technology. The Elekta Infinity™ radiation treatment system garnered the #2 ranking with a score of 84.4, improving its score over the 2010 report.
The 2011 KLAS report – the result of interviews with 213 U.S. provider organizations – referenced respondents’ regard for the Perfexion system’s technological sophistication, making “treating very complicated tumors in a difficult spot easy for providers,” and for the radiosurgery platform’s unprecedented uptime statistics. The report summarized customer opinion by noting: “The speed, accuracy, reliability, and sophistication of the treatments all came together for the Gamma Knife Perfexion to earn the highest score in the study by a 10-point margin.”
Gamma Knife® surgery is a gentler alternative to traditional brain surgery for illnesses such as metastatic disease – cancer that has traveled to the brain from elsewhere in the body. The system delivers thousands of low-intensity radiation beams to one or more targets in a single session. Leksell Gamma Knife Perfexion provides even greater speed and ease of use than previous versions, especially for treating multiple metastases.
Read more at: http://www.elekta.com/healthcare_international_press_release_20071325.php.
*Radiation Therapy 2011: A Dose of New Technology, © November, 2011 KLAS Enterprises, LLC. All rights reserved.
Extend frame system
By the end of 2011, as many as nine U.S. medical centers will be offering multi-session Gamma Knife® surgery with Extend™ to treat patients with larger tumors or lesions close to critical structures located in the brain and skull base. Extend technology allows clinicians to non-invasively immobilize the patient’s head, making repeatable or multi-fraction Gamma Knife surgery feasible for these cases.
Used with Leksell Gamma Knife® Perfexion™, the key components of Extend are patient-friendly fixation devices, such as a vacuum assisted bite block and head support with vacuum pillow. Accurate repeat fixation is ensured with a one-time use of a CT box to obtain precise stereotactic reference points, followed by repeat checks using reposition check instruments for each Gamma Knife session.
Among the first U.S. centers to acquire Extend, University of Virginia (UVA, Charlottesville, Va.) physicians have employed Extend in 15 cases, mostly for benign tumors of the meninges.
“Extend is clinically advantageous for some patients because it combines Gamma Knife technology with a fractionated approach,” says Jason Sheehan, M.D., Ph.D., Alumni Professor in radiation oncology and neurosurgery at UVA and co-director of UVA’s Gamma Knife Center. “Specifically, you get the accuracy, precision, high dose and steep gradients of Gamma Knife surgery along with the benefits of fractionation. The true advantages of this system will become more evident as institutions begin to publish their results following its use.”
Demonstrations of Extend, among other neuroscience solutions, will be available at Elekta booth #1040 during the 2011 Congress of Neurological Surgeons (CNS) Annual Meeting, October 3-5 at the Walter E. Washington Convention Center in Washington D.C. Read more about how physicians at Barnes-Jewish Hospital’s Gamma Knife of St. Louis and UW Medicine Gamma Knife Center at Harborview in Seattle are treating patients with Extend: http://www.elekta.com/healthcare_international_press_release_20071308.php.
A comprehensive reference for current techniques for radiosurgery of the brain
Stop by Elekta booth #1040 during the 2011 Congress of Neurological Surgeons (CNS) Annual Meeting, October 3-5, at the Walter E. Washington Convention Center in Washington D.C., enjoy a brief demonstration of any of the below Elekta solutions, and receive a complimentary copy of Intracranial Stereotactic Radiosurgery.
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Leksell Gamma Knife® Perfexion™: Voted Best in KLAS for 2011, Radiosurgery Systems
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Leksell GammaPlan® 10: Upgrade to enhanced planning power
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Elekta Neuromag® TRIUX™: The next level in functional mapping
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Leksell Stereotactic System™: The gold standard for minimally invasive neurosurgery
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SonoWand Invite™: Intra-operative 3D imaging – on demand
Learn more about Elekta complete suite of neuroscience solutions at: www.elekta.com/neuroscience.
Institution: Hospital Na Homolce, Prague, Czech Republic
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Patient 1: 63-year-old male, diagnosis: kidney cancer, multiple brain metastases
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Patient 2: 48-year-old male, diagnosis: lung cancer, multiple brain metastases
Repeated Leksell Gamma Knife® Radiosurgery
Leksell Gamma Knife® Perfexion™ with its enlarged space inside the collimator helmet allows unlimited reach to all multiple brain metastases with standard attachment of the stereotactic frame (positioned low and centered on the midline of the head) in one session. In cases where new brain metastases are detected, radiosurgery can be repeated.
Leksell GammaPlan® allows the import of previous treatment plans, their co-registration with current images and superimposition of old treatment plans on them. This planning feature makes it easy to identify new brain metastases unequivocally and evaluate regression of previously treated ones at a glance.
Download the entire case study at: http://bit.ly/qyGuRe
- Largest Neurosurgical Center in Russia Acquires Elekta’s Leksell Gamma Knife Perfexion February 6, 2012Russia’s first Leksell Gamma Knife® Perfexion™ system has found a home at the renowned N.N. Burdenko Neurosurgical Institute, just a five-minute car ride from Moscow’s Red Square. On June 2, 2011, a 59-year-old woman was the first Perfexion patient, receiving Gamma Knife® radiosurgery to treat tumor tissue that remained following open surgery. Now, eight mon […]
- Largest Neurosurgical Center in Russia Acquires Elekta’s Leksell Gamma Knife Perfexion February 6, 2012N.N. Burdenko Neurosurgical Institute improves treatment of patients with multiple metastasesRead more... […]
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