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Intensity Modulated Radiotherapy (IMRT) | Gamma KnifeŽ Radiosurgery
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Gamma Knife


Indications and Results
All types of brain tumors may be treated using this technique because it does not rely on variable tissue sensitivity to radiation. All cells within a radiosurgical treatment volume receive a toxic dose of radiation creating cell kill. The DNA is destroyed and so are critical proteins responsible for cell division. However, because the amount of radiation delivered has to be decreased as target size increases, physicians are limited to treating tumors less than 4 cm. in average diameter.


Meningiomas:
  • 94% tumor control rate
  • 10% edema risk 2% will require surgical removal of tumor for treatment of edema
  • 2% risk of permanent injury
  • Torcular meningioma, prior to and 14 months after
    Gamma Knife radiosurgery.



    Acoustic Neuromas:
  • 97% tumor control rate
  • less than 1% facial neuropathy risk (near-zero risk in tumors less than 1 cm in diameter)
  • 60% hearing preservation rate.
  • Acoustic neuroma before, 3 months and 9 months after
    Gamma Knife radiosurgery.



    Brain Metastases: (regardless of tissue type)
  • 90% tumor control rate
  • 6% edema risk
  • 2% permanent deficit risk
  • More than one tumor may be treated in one session.
  • Renal cell carcinoma brain metastasis before and 1 year after
    Gamma Knife radiosurgery.



    Glioblastoma Multiforme: (Astrocytoma Grade 4) and Anaplastic Astrocytomas (Grade 3)
  • 93% response rate with median tumor progression free interval of 12 months
  • Improvement in overall survival. Synergistic when combined with Immunotherapy. Some patients are now more than 4 years from their initial diagnosis treated with this powerful regimen. Patients and their family members of survivors of this disease using this regimen may be contacted.
  • Glioblastoma Multiforme (Grade 4 astrocytoma) before
    a 3 1/2 years post immunotherapy. Biopsies of the
    residual mass on the right showed only dead, necrotic tissue.



    Primary Low Grade Gliomas of the Brain:
  • 95% response rate.
  • Follow-up not yet sufficient for results.



  • Craniopharyngiomas, Pituitary Adenomas, Ependymomas, Medulloblastomas, Pineal tumors and other types:
  • From 80-98% tumor control rates.



  • Arteriovenous Malformations: (AVMs):
  • 80% complete obliteration by 2 years
  • 6% complication rate
  • 3% permanent complication rate.
  • Arteriovenous malformation (AVM) before, and 2 years
    after Gamma Knife radiosurgery.



    Tremor of Parkinson's Disease (Gamma Knife thalamotomy)
  • 80% Good to excellent relief of tremor occurring within 3 months of treatment



  • Trigeminal Neuralgia: (Tic Doulereux)
  • 75% Good to excellent relief of pain
  • 55% are pain-free off all medication. The remained of patients are pain-free with lowered dosages of medications.
  • The effect of treatment takes an average of 4 weeks to occur post Gamma Knife.
  • 8% risk of sensory loss on the face.
  • Near zero risk of anesthesia dolorosa.

  • The patient's trigeminal nerve accurately targeted
    for a gamma Knife radiosurgery treatment.



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