Standard of care
Gamma Knife surgery is what is known as “a standard of care” for its indications. In the last five years, the number of patients treated per year has increased by 300%. More than 30,000 patients every year worldwide are treated with Gamma Knife surgery.
Leksell Gamma Knife is a Swedish invention. In 1968 the first Gamma Knife was installed at the private hospital Sophiahemmet in Stockholm, Sweden. The first in the U.S. was installed in 1987 in Pittsburgh. Over the years, Gamma Knife has been refined and improved with advances in engineering radiation physics, robotic controls and computerized treatment planning.
Gamma Knife surgery is the only radiosurgery (or radiotherapy) specifically approved by the FDA for treatment of brain mets.
Surgery without a knife
Gamma Knife is not actually a knife at all. It is a very precise and effective instrument that uses cobalt 60 radiation to treat the brain. Since Gamma Knife uses radiation, this treatment is often called radiosurgery. Using this method, doctors are able to focus radiation directly, and very precisely, on the target in the brain without affecting surrounding healthy tissue.
Radiosurgery (one-session treatment) has such a dramatic and precise effect in the target zone that the changes are considered ‘surgical’. Through the use of 3D computer-aided planning and the high degree of immobilization of the patient, the treatment can minimize the amount of radiation to surrounding healthy brain tissue.
Individually, each radiation beam is too weak to damage the normal tissues it crosses on the way to the target. But when focused precisely on that target, the beams intersect and the combined radiation is sufficient to treat the targeted area.
Treatment method
Gamma Knife surgery is a non-invasive surgery for neurological diseases which does not require the skull to be opened for performance of the operation. The patient is treated in one session and can normally return home the same day as or the day after treatment.
Gamma Knife precision is submillimeter—about the thickness of a human hair. Stereotactic radiosurgery is routinely used for brain tumors and lesions. It may be the primary treatment, utilized where a tumor is inaccessible by surgical means, or as a boost or adjunct to other treatments with a recurring or malignant tumor.
Alternative to open surgery
Gamma Knife surgery is an alternative or can be complementary to open surgery. The procedure is normally performed by a neurosurgeon accompanied by a radiation oncologist and medical physicist.
Gamma Knife surgery provides lower complication rates than open surgery. Both mortality and morbidity rates are lower for radiosurgery. (Dheerendra Prasad, University of Virginia, USA Gamma Knife Surgery and Microsurgery, Clinical Review, 2002.)
Gentle treatment
Since no incision is made, the risk of surgical complications is low. The patient's head does not have to be shaved and side effects are few. Treatment is much shorter than conventional surgery and causes only minor discomfort. Also, the patient can leave the day of surgery or stay overnight for observation, compared with several weeks for traditional surgery. The treatment is complete in one session and seldom takes more than an hour or two. The full effects of Gamma Knife surgery may not be seen for several months following treatment.
Healthcare cost saving
Gamma Knife surgery is highly cost effective and generally fully reimbursed by insurance. Treatment using Gamma Knife is far less expensive for healthcare institutions and the patient than traditional surgery. In most cases the convalescence period is extremely short while the corresponding period following surgery may extend several months. The cost for radiosurgery is normally half the cost for open surgery. Most important, Gamma Knife surgery offers a more favorable quality of life before, during and after the procedure.
