Neurosurgery without a scalpel!

[Smilemaker100]

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I was wondering if anyone in this forum has had experience using the Gamma-Knife radiosurgery technique for brain tumors, . Patients don't have to undergo anesthesia and there is no incision for this procedure (despite its misleading name). It is done while they are fully awake! It involves aiming radiation at an intracranial tissue target.

I was wondering why it takes so much time (weeks, months and years) to observe the results.

Neurosurgery/Neurology is one of my intellectual interests and I found this very interesting.

http://www.mayoclinic.com/health/gamma-knife-radiosurgery/HQ00736

 

[mpp]

Gamma knife is fairly common in the US to treat certain brain tumors. The reason it takes time to see results is similar to any use of radiation. Radiation works by damaging DNA and tends to effect cells after several replications cycles. Fast growing tumors such as cancer are killed more quickly than slow growing benign tumors treated with gamma knife such as meningiomas and acoustic neuromas.

 

[cmb81]

i thought radiation oncologists mainly used the gamma knife....but what do i know. im still in ugrad.

 

[mpp]

The neurosurgeon's role in gamma knife treatment varies. In a few centers the radiation oncologists do it all. At some places the neurosurgeon's place the frame and the radiation oncologist does the planning and treatment. At other places the neurosurgeon places the frame and does the planning while the radiation oncologist does the treatment. Either way, most of the patients come through neurosurgery since the most commonly treated conditions are arteriovenous malformation and tumor.

 

[jagm69]

Hello all, I'm new here. Just want to add a comment on the post made by smile maker, I think Gamma Knife is a very useful tool among the neurosurgeos armamentarium because of its advantages, mentioned before, but it's still far from being a panacea. In addition, here in south america, we do not have access to such a therapy as you wuold in the US or Europe, so I think open surgery remains the procedure of choice for many illnesses included tumors and AVM's in many cases. Finally, now a days, a multidisciplinary approach to patients is the standard for patient caring, then oncologists, neurosurgeons, psychologists, etc are needed to help people cope with this kind of problems. I hope in the future, not too far, this will be substituted by less invassive procedures each day; all in the benefits of our patients
J. Galvis, NS Resident (Maracaibo, Venezuela)

 

[mpp]

The gamma knife doesn't really offer that many advantages over traditional frame-based stereotactic radiosurgery using X-rays from a linear accelerator. The gamma knife offers slightly more precision in targeting and the ability to treat multiple lesions at the same time.

The cyberknife is newer technology that uses a linear accelerator mounted on a robotic arm and gives the precision of gamma knife without the frame. Plus it adds the ability to treat tumors outside of the head (gamma knife is limited to lesions in the head) and to fraction the radiation dose (gamme knife is a one-time treatment).

Traditional whole brain radiation is also still used for certain conditions, especially for multiple lesions such as metastases. Sometimes it is used in combination with radiosurgery (with either gamma knife or a linear accelerator).