What is Gamma Knife radiosurgery?
Gamma Knife radiosurgery, or scalpel-free surgery, is an alternative form of treatment as opposed to open craniotomy. It is a non-invasive surgical procedure performed with local anesthesia as a one-day treatment, with patients experiencing minimal discomfort.
With this method, a high dose of radiation is delivered with absolute accuracy to small intracranial targets (tumors or focal lesions) in one session, leaving the surrounding tissue unaffected.
No recovery time is necessary, which is extremely important for the patients, as they may resume their normal activities one day after the procedure. It is the ideal treatment for pediatric tumors, since the radiation dose delivered to the healthy brain tissue is very small. The complications are minimal and quite insignificant compared to open neurosurgery.
Gamma Knife radiosurgery offers major benefits to brain surgery, changing the state of affairs in the field of neurosurgery. It is a well-known fact that in certain brain disorders, surgical approach is linked to significant morbidity and mortality, due to various factors, such as the depth and the exceptional nature of the lesion, as well as its position in relation to the arteries, nerves and other vital brain centers.
Treatment with Gamma Knife does not remove the target, but it distorts the DNA of the targeted tumor cells. As a result, these cells lose their ability to reproduce, break up and are removed with the help of the immune system. In arteriovenous malformations, radiosurgery increases vessel wall thickness, and the vessels in turn become unobstructed. The clinical results in benign tumors and vascular malformations become evident in about 6-24 months, while in malignant and metastatic tumors, they may be evident in as early as 2-3 months.
The procedure may be performed exclusively as the first option treatment or in combination with other treatment techniques (surgery, radiotherapy, embolism). Moreover, it may deliver doses of radiation to more than one target during the one session, without any further complications from irradiating part of or the entire brain.
The technique requires close collaboration between the neurosurgeon and the radiation oncologist to decide on the most suitable treatment per patient, and determine the target and the radiosensitive areas, the treatment doses and the natural tolerance limits, the aim of the treatment, and the possible combination of other treatment options. Participation of a radiation physicist is also necessary, as they formulate the treatment plan for the optimal adjustment of the dose to the target.
Clinical need for greater potential
Taking into account the most common indications for Gamma Knife radiosurgery, approximately 375 people per one million are considered eligible candidates to undergo the specific procedure. This number will surely increase in the future.
The incidence of cancer is expected to increase by 50%, with 16 million new cases expected to arise by the year 2020. Bearing in mind that about 20-40% of the total number of cancer patients will exhibit brain metastases, it is evident that Leskell Gamma Knife will play a significant role in the healthcare services provided in the future.
Dr.Sanjay Mongia
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