Posts Tagged ‘Stereotactic radiosurgery’
On March 4, a 69-year-old male patient was Riverside & University of Virginia Radiosurgery Center’s 1,000th patient to be treated since the facility opened. Clinicians used their Leksell Gamma Knife® to treat a metastatic melanoma in the patient’s brain. Coincidentally, the patient also had undergone radiosurgery earlier for lung and chest wall nodules, benefiting that time by Riverside’s Elekta Synergy® S. Whether the disease is intra- or extra-cranial, Riverside can offer patients a highly targeted radiosurgical solution.
Radiosurgery is a form of radiation therapy that emphasizes higher than typical radiation doses applied with extreme accuracy and over a very limited number of therapy sessions. Gamma Knife surgery is accomplished nearly exclusively in one treatment, while linear accelerator-based radiosurgery involves one to five sessions or “fractions.” Riverside worked with the University of Virginia to establish the facility, starting Gamma Knife treatments in June 2006 and Elekta Synergy S treatments in May 2007.
“Some centers economize by acquiring a single general system to perform radiosurgery for all targets in the head and body,” says Riverside radiation oncologist Ronald Kersh, M.D. “However, if you’re serious about attaining the highest radiosurgical accuracy possible, you need to consider dedicated treatment systems. Leksell Gamma Knife is viewed as the gold standard for accuracy in treating intracranial targets, such as metastases and functional disorders. Similarly, Elekta Synergy S not only provides exceptional accuracy for extracranial targets, but it also complements Gamma Knife by enabling treatment of larger intra-cranial lesions located in critical areas that would benefit from a multi-fraction approach, such as large meningiomas or optic nerve tumors.”
Read the rest of Riverside’s story here:
<http://www.elekta.com/healthcare_international_press_release_20071045.php>
Dr. Ronald Kersh
Leksell Gamma Knife Perfexion – http://www.gammaknife.com
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Top neurosurgery treatment uses non-invasive radiosurgery with stereotactic frame for unmatched accuracy
There are few words more frightening than “cancer.” To learn that it has spread to your brain can be devastating. Yet there is hope, in the form of non-invasive treatment that doesn’t require surgery and is medically proven to be effective.
Gamma Knife radiosurgery has been used for decades to treat brain tumors and brain disorders, and thanks to constant advancements in technology, remains the choice of neurosurgeons worldwide. In fact, almost half a million people have been treated with Gamma Knife surgery, with a high rate of success.
Studies show that local control exceeds an average of 85% for the management of tumors in any brain location. And, despite the name, there is no blade or knife – it’s called Gamma Knife because of the surgical precision and effectiveness. So there’s no incision or blood, and minimal risk of complications.
Defining Your Options
It can be difficult to sort out competing claims, especially if your doctor isn’t providing you with information. To begin, let’s define a few terms that you probably aren’t familiar with if you’re not in the medical field.
Radiosurgery is the delivery of a single, large dose of radiation to a specific target in the brain with surgical precision. The radiation will react on a molecular level with the cancer cells and stop their reproduction, which kills the cancer.
Stereotactic radiosurgery, as is used in Gamma Knife surgery, means a 3D reference frame will be attached to your head during the procedure. This type of frame is used for almost all major neurosurgery, and it is simply a lightweight metal frame with pins that are secured to your head in four spots. Patients say it can be somewhat uncomfortable for the few hours you wear it, but the absolute assurance of accuracy is worth it.
A Moving Target – Why you want to be ‘Framed’
With Gamma Knife surgery, your head frame locks into the high precision and secure treatment delivery system – it almost looks like you’re being inserted in a dome-shaped giant hair dryer. There is absolute stability, which leads to greater accuracy. It’s like putting a camera on a tripod rather than trying to hold it steady.
Because large doses of misguided radiation can harm healthy brain tissue, it’s vital that only the affected area in the brain is treated. Gamma Knife is guaranteed accurate to 0.5mm – the size of a pinpoint. Gamma Knife is used to treat delicate brain disorders such as tumors, vascular malformations*, and functional problems such as trigeminal neuralgia*.
*Currently in clinical research.
Fast, Gentle, Safe
Because Gamma Knife radiosurgery is so accurate, the full dose of radiation can be delivered during a single session and you don’t have to worry about excess radiation – the Gamma Knife system’s intelligent design keeps radiation from the rest of the body.
The actual Gamma Knife surgery is a gentle treatment with little or no pain that can be performed on an outpatient basis in a few hours. There are minimal side effects – some people may complain of a headache, which can be treated with aspirin. There is no loss of hair or nausea, as with some treatments. Recovery time is usually a few days with no need for convalescence or rehabilitation.
Unlike invasive surgery, it can be used repeatedly over time if new brain tumors occur – which would be very risky with open skull surgery. And because it’s noninvasive, Gamma Knife surgery can be used to treat metastases in surgically inoperable tumors.
Over 500,000 patients have been treated with Gamma Knife surgery. When most doctors are asked what they would choose for their family members, they choose Gamma Knife because they trust the clinical evidence (2,000 published papers) and know that it works.
WESTPORT, Sep 04 (Reuters Health) – Stereotactic radiosurgery slows progression and improves survival in some patients with metastatic disease to the brain, according to a report in the August issue of Neurosurgery.
Although chemotherapy helps few patients with intracerebral metastases, external beam radiotherapy, radiosurgical ablation, and surgical removal of metastases have demonstrated some effectiveness, the authors explain.
Dr. Joseph C. T. Chen, of the University of Southern California, in Los Angeles, and colleagues reviewed their series of 190 patients who underwent gamma knife stereotactic radiosurgery for intracerebral metastatic tumors.
Median survival after radiosurgery was 34 weeks, the authors report, but survival was better among non-melanoma patients (39 weeks) than among melanoma patients (28 weeks). These survival figures are similar to those reported in open surgical series.
Median survival was significantly longer in patients with controlled disease (more than 50 weeks) than with active disease (28 weeks), the investigators note, and in patients with posterior fossa metastases (40.5 weeks) rather than supratentorial lesions (30.3 weeks).
Most metastases followed during the study were controlled for the lifetime of the patient, the report indicates, with only 6% showing late progression and only 6% progressing despite therapy.
“In the absence of clear data demonstrating the advantage of one modality over the other with respect to overall survival,” the authors conclude, “the choice between surgery and radiosurgery must be made on the basis of time, cost, patient acceptance and the availability of the procedure.”
“Radiosurgery should not be considered as a panacea or a miracle treatment,” Dr. Chen told Reuters Health.. “It simply is a less invasive, better tolerated, and safer alternative to open surgical intervention and whole brain irradiation for most, but not all patients with metastatic disease to the brain.”
He added, “We must recognize that just because we are trained as neurosurgeons to use a knife, this may not be the best treatment for all patients. Neurosurgeons must change the nature of their practice to be able to use radiosurgical methods in the treatment of their patients.”
To read the entire article – Visit Oncolink.com
For more information on Brain Metastases, click the link below to process to www.livingwithbrainmets.org – Living With Brain Mets
Local Control of Brain Mets
Recent studies estimate that 25 percent of all cancer patients – particularly patients with melanoma, lung cancer, or advanced breast cancer – will develop brain metastases and require whole brain therapy. While whole brain radiotherapy is a treatment option, it also subjects healthy brain tissue to radiation dosages that may have negative side affects or limit the amount of therapeutic dose that can be applied in the event of a re-occurrence. In addition, whole brain radiation requires an interruption in the chemotherapy treatments that are so important to maintaining tumor control.
Dr. Christopher M. Duma, Neurological Surgeon at Hoag Memorial Hospital Presbyterian in Newport Beach, California will discuss the use of Leksell Gamma Knife® Perfexion™ to treat multiple brain metastases in a single session. Gamma Knife® surgery always has been especially good at treating very small targets with little or no damage to healthy tissue; but Perfexion is able to treat several targets faster and more efficiently making it a viable option of patients with brain metastases. The result is a fast and effective treatment for brain metastases that is easier on the patient, reduces the damage to healthy tissue that may limit future treatment options, and allows for concomitant chemotherapy for optimum primary tumor control.
Stereotactic Radiosurgery of the Spine
While Gamma Knife® surgery was initially invented to treat inoperable cancers and disorders in the brain, now the kind of stereotactic treatment precision established by Elekta can be applied to extra-cranial tumors. Today, the latest advancements in image guidance and dynamic arc delivery pioneered by Elekta combined with Leksell-quality fixation options support Stereotactic Radiosurgery (SRS) and Stereotactic Radiation Therapy (SRT) anywhere in the body to deliver optimal dose to the tumor, while protecting vital organs like the spinal cord.
Dr. Peter C. Gerszten, Associate Professor of Neurological Surgery and Radiation Oncology at the University of Pittsburgh Medical Center and co-editor of Spine Radiosurgery, will discuss the use of Elekta Axesse™ to perform stereotactic radiosurgery for spine and paraspinal lesions. According to Dr. Gerszten, “Axesse is fully optimized for SRS and SRT and therefore well suited for spine radiosurgery, providing patients a fast, safe, and effective treatment alternative or as an adjunct to open surgical intervention.”
More than sixty years ago, Professor Lars Leksell developed a three-coordinate head frame and revolutionized the field of stereotaxy. Twenty years later he conceived of replacing the surgical precision of the neurosurgeon with precisely targeted radiation, and invented the field of stereotactic radiosurgery (SRS). Today, Leksell Gamma Knife® Perfexion™ is still the benchmark upon which all other SRS methods are measured; Perfexion equipped with Extend Program*™ is capable of treating cancers of the head and neck and lesions previously unsuitable for Gamma Knife surgery; And Elekta Axesse™ supports SRS and SRT anywhere in the body making it a versatile cross-over solution for neurosurgery and oncology .
According to President and CEO of Elekta North America, Joseph K. Jachinowski,
“Since its very foundation, Elekta has sought to develop technology that allowed practitioners to achieve specific clinical objectives. Today Elekta Neuroscience is still developing technology to address the most challenging cases in neurosurgery and oncology, creating new treatment possibilities that are redefining what we call, human care.”
*Extend requires 510(k) review and is not yet commercially available in the U.S.
Visit with Elekta tt the 2009 American Association of Neurological Surgeons (AANS) Annual Meeting, May 4-6 at the San Diego Convention Center,
Simulation – Simulation uses x-rays to mirror the radiation therapy treatment, allowing patient position and radiation field to be defined
Stereotactic radiosurgery – Stereotactic refers to the location of a point within a body through the combination of three coordinates combined and calibrated with an external reference. Stereotactic radiosurgery relates to ablating a tumor or other target using high energy x-ray photons after determining its position via the external reference system. Treatment is performed in a single treatment session
Stereotaxy – Neurosurgical technique enabling the localization of a given target within the brain in terms of a geometric axis system
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