Radiosurgical Gamma Knife is a device used to treat benign and malignant brain tumors as well as some of the other diseases of the nervous system. Gamma Knife (also known as the Leksell Gamma Knife-from the name of one of the originators) was invented in Sweden in the 60s. The principle of the intervention is to deliver a high dose of cobalt radiation concentrated in a small area.
A treatment of brain tumors is a combination therapy consisting of surgery, radio – and chemotherapy. In case of benign tumors radiation therapy may be optional but in case of malignant tumors is a necessity. One of the most excellent radiotherapy techniques is radiosurgery, namely the 3-dimentional radiation, which can be carried out by Gamma Knife device.
Gamma Knife surgery is a variation that uses a cobalt beam instead of a scalpel. 20 grams of radioactive cobalt produces 192 beams that individually are not dangerous for the brain but when combined they cause the death of the nerve cells.
The device also provides the ability of the composite planning, which is the control of the diameter of the beams and permission to switch on and off different beams in order to avoid damage to the certain brain structures, so that the side effects can be minimized.
With the help of the Gamma Knife technology, malignant and benign tumors of the brain can be treated . This method is particularly applicable in the case of multiple changes, inoperable tumors, or those resistant to radiotherapy as well as in case of a vestibular schwannoma or pituitary tumors. With the Gamma Knife hemangiomas of the brain, some types of tremors, and facial neuralgia can be treated. Irradiated tumor cannot be larger than 4 cm.
Gamma Knife device usage is completely non-invasive and painless. During the procedure, the skull is not opened and there is no need for shaving the head. The procedure takes from 20 minutes to 2 hours and the patient can go home the same day. It is estimated that the cost is lower than the cost of traditional neurosurgery (by 20-30%).
Gamma Knife treatment method consists of several steps. The first is fixing of the frame (under local anesthesia). The frame is used to determine the stereotaxic fixed points, on the basis of which the treatment is planned. A further step is to perform a magnetic resonance imaging with frame fixed to the head of the patient. The next step is the planning of radiation by using a special console. In planning the rays of different diameters are used in order to cover all of the tumor mass but the safety of the patient must be also taken into account. The last step is irradiation with the Gamma Knife device. During the entire procedure the patient is in contact with his doctor.
Currently, the Gamma Knife device is used in approximately 300 hospitals, mostly in Japan and in the United States. Approximately 600 thousand patients worldwide have been treated with this method.
Written by: Magdalena Mroczek
Source:
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Clinical outcomes of reirradiation of brain metastases from small cell lung cancer with Cyberknife stereotactic radiosurgery.
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A Multi-institutional Study of Factors Influencing the Use of Stereotactic Radiosurgery for Brain Metastases.
Hodgson DC, Charpentier AM, Cigsar C, Atenafu EG, Ng A, Bahl G, Zadeh G, Miguel JS, Menard C.
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4.http://neuroonkologia.com.pl/poradnik_net.pdf
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