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Elekta | Focus Magazine

Gamma Knife leader on track for next 10,000 patients


Japan’s Yokohama Rosai Hospital a prolific contributor to global total of individuals benefiting from Leksell Gamma Knife treatment

As Elekta celebrates the 50th anniversary of clinical Gamma Knife® radiosurgery, clinicians at Yokohama Rosai Hospital can take pride in their center’s contribution to the worldwide volume of 1.1 million patients treated since 1968. Since 1992,  Yokohama Rosai Hospital has treated nearly 11,000 patients with Leksell Gamma Knife technology, hitting the 10,000th patient treated in 2016 – a 68-year-old woman with an acoustic neuroma – making it among the busiest Gamma Knife centers in the country.

“We treat about 12-15 patients each week,” says Takashi Shuto, MD, Director of Neurosurgery at Yokohama Rosai Hospital. “Since we acquired the Extend system for our Leksell Gamma Knife® Perfexion™ unit, we are the busiest site in Japan for performing multi-session radiosurgery.”

The undisputed gold standard for the treatment of intracranial indications, Gamma Knife radiosurgery is a gentler alternative to traditional brain surgery and whole brain radiation therapy for illnesses such as metastatic disease, which is cancer that has traveled to the brain from elsewhere in the body. With pinpoint accuracy, Leksell Gamma Knife® delivers up to thousands of low-intensity radiation beams to one or more targets in single or multiple sessions.

Yokohama Rosai Hospital installed its first Leksell Gamma Knife (B model) in 1992. Since then, clinicians have been working to treat complex and challenging brain condition, such as malignant and benign tumors, in addition to vascular and functional cerebral disorders without harming surrounding healthy tissue.

At Yokohama Rosai Hospital, brain metastases are the most common indication, with about 350 of the 600 cases in 2017, including lesions that required fractionated (multi-session) therapy (≈ 60 cases). Other indications frequently seen are arteriovenous malformations and acoustic neuromas.

“I believe we have entered an era in which highly focused stereotactic radiosurgery, such as that provided by Leksell Gamma Knife surgery, will become an increasingly important treatment option,” Dr. Shuto notes. “Our mission is to continue contributing to our patients’ lives with Gamma Knife radiosurgery as this technology continues to evolve.”

As part of the strategy to develop their Leksell Gamma Knife radiosurgery program in 2018 and beyond, Yokohama Rosai Hospital is implementing a plan to apply fractionated radiotherapy for the clinic’s principle indication, metastases. The intent is to help reduce long-term complications and identify and establish optimized dose fractionation based on tumor volume, Dr. Shuto adds.

Thoughts on a half-century of Gamma Knife use worldwide

Yokohama Rosai Hospital has been actively using Gamma Knife in its treatment offerings since it opened 26 years ago. Dr. Hideyo Fujino, who established the Gamma Knife Center, established the basis for Gamma Knife treatment and the case volume has been increasing year-on-year since 1992.

“There were over 600 cases of Gamma Knife treatment during the Model B period and cooperation from many staff involved with the treatment was inevitable,” Dr. Shuto recalls. “Over the last 50 years since the clinical launch of Leksell Gamma Knife and a quarter-century since the start of treatment at our facility – which has seen rapid medical progress – Leksell Gamma Knife has been at the vanguard of the move toward minimally invasive neurosurgery.

“Leksell Gamma Knife has enabled the safe treatment of lesions located deep within normal brain tissues, which made Gamma Knife radiosurgery the last hope and basis of support for patients with malignant brain tumor,” he adds. “And our department also is engaging in craniotomy procedures and the best neurological treatments are possible by application of the appropriate treatment. We would like to keep building our experience with Gamma Knife radiosurgery so we can contribute to the advancement of this critical therapy option.”

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