Sep 07, 2018
Moscow’s Sklifosovsky Research Institute of Emergency Care contributes its share of patients benefited during the 50th year of clinical Gamma Knife radiosurgery
A 62-year-old woman with a meningioma recently became Sklifosovsky Research Institute’s 1,000th patient to be treated with the clinic’s Leksell Gamma Knife® Perfexion™. The Perfexion radiosurgery system is the centerpiece and sole radiotherapy unit of the Institute’s Radiosurgery Center, which opened on April 10, 2016 in Moscow.
“We are delighted to be an official member of the global Gamma Knife community, particularly this year as the technology marks its own special milestone of 50 years of clinical use,” says Sklifosovsky Institute neurosurgeon Viacheslay Rak, MD. “Despite all of the new technologies and techniques that are gaining acceptance – such as deep brain stimulation [DBS] and focused ultrasound – Leksell Gamma Knife maintains its gold standard status as a safe and effective treatment modality for intracranial cases, including ablative functional neurosurgery.”
The Sklifosovsky Research Institute Gamma Knife team
The center used its Perfexion system to treat 200 patients in the Radiosurgery Center’s first two months, Dr. Rak recalls.
“Currently we’re treating between 18 and 20 patients each week, mostly individuals who have metastases, meningiomas or acoustic schwannomas,” he adds.
The acquisition of Leksell Gamma Knife Perfexion at Sklifosovsky Research Institute of Emergency Care was to expand the neurosurgery department’s treatment options.
Treatment plan for a 41-year-old patient with an acoustic schwannoma, which had been causing progressive hearing loss.
“The system provides an alternative for patients who have contraindications for open surgery or who could benefit from a less invasive treatment,” Dr. Rak says. “Leksell Gamma Knife Perfexion is a welcome addition to our ‘closed loop’ patient management system, which means that if the case calls for it every patient can be treated with the comprehensive range of cutting-edge neurosurgical technologies in different combinations – such as Gamma Knife® radiosurgery, microsurgery, endoscopy and endovascular treatment – as we strive to provide the optimal, personalized therapy for each patient.”
Another noteworthy aspect of the neurosurgery department is its multidisciplinary team, which comprises neurosurgeons, neuroradiologists, a radiotherapist, medical physicists and nurses.
A typical multiple mets case. The treatment plan is for the 71-year-old patient’s third Gamma Knife radiosurgery. Despite the high tumor burden (38), there are no radiation-induced complications.
“All of the team members are highly qualified specialists who consistently rank at the top of their respective discipline in terms of knowledge, experience and skills,” Dr. Rak observes. “They participate in scientific events all around the world to make all of the treatments the department offers – including now Gamma Knife radiosurgery – as effective as possible.”
The Radiosurgery Center is the only entity in Moscow’s healthcare department that is able to offer Gamma Knife radiosurgery free-of-charge to city residents (80% of caseload) through the public healthcare program.
A medium-sized incidental meningioma in a 56-year-old female patient.
|A very common target of Gamma Knife radiosurgery is metastatic brain cancer. Also called secondary brain cancer, a metastasis originates as a primary tumor elsewhere in the body. Cancer cells break off and are carried by the bloodstream or lymph system to other parts of the body, including the brain, where they lodge and grow. Spreading of the tumor is known as metastasis.
The most common cancers that spread to the brain include lung, breast, melanoma, colon and kidney – although any type of cancer can spread to the brain. Metastatic tumors are the most common mass lesions in the brain, even more common than many primary tumors. Symptoms may include headache, seizure, nausea, vomiting, cognitive or motor dysfunction, or photophobia.
Stereotactic radiosurgery is a preferred modality for lesions such as non-small cell lung cancer (NSCLC), renal cell carcinoma, and melanoma. It is frequently used to treat the resection cavity of a brain metastasis, particularly in patients with breast metastatic disease.
While surgical resection is considered standard of care for large solitary metastases, it must be in an area of the brain where it is safe to operate. Minimally invasive Gamma Knife radiosurgery provides exceptional accuracy, making it particularly well-suited to treat metastatic tumors – including larger tumors or those abutting critical structures such as the optic chiasm – in terms of tumor control and lack of complications.
Also, unlike whole brain radiation therapy (WBRT), the precision and accuracy of Leksell Gamma Knife enable additional treatments over time in cases where brain metastases recur.
Clinicians can find more information about Leksell Gamma Knife – including the latest generation model, Leksell Gamma Knife® Icon™ – at elekta.com/gammaknife.