The Gamma Knife team at Wake Forest University Baptist Medical Center will treat a patient with a malignant brain tumor using Gamma Knife stereotactic radiosurgery. The live webcast of the procedure takes place on Tuesday, January 21 at 5pm EST.

What Is Gamma Knife®
Gamma Knife stereotactic radiosurgery (SRS) is a method of delivering an ultra-precise, highly focused dose of radiation to an intracranial target.
Based on nearly 40 years of clinical experience, Gamma Knife SRS has become the treatment of choice for selected benign and malignant brain tumors and vascular malformations involving the brain, as an alternative to conventional open surgery.

Precise and powerful, Wake Forest University Baptist Medical Center’s 22-ton Gamma Knife is the only unit of its kind in North Carolina.

The treatment plan is carefully designed by a team of neurosurgeons, radiation oncologists and radiation physicists who use high-tech computer planning to precisely conform the radiation dose to the size and shape of the lesion. The unit aims 201 narrow pencil-beams of radioactive cobalt-60 at the lesion. The beams focus precisely on the target tissue, thus minimizing radiation effects to surrounding healthy brain tissues. Gamma Knife can be administered in single or multiple fractions.

Indications for Gamma Knife
Indications for Gamma Knife SRS include benign and malignant primary brain tumors, brain metastases, meningiomas, acoustic neuromas, arteriovenous malformations, trigeminal neuroma, movement disorders, and other localized intracranial benign or malignant lesions.

Who Are Appropriate Candidates for Gamma Knife?
In general, Gamma Knife SRS is appropriate for patients with brain lesions 4 cm or less in maximum diameter, where open surgical options have been exhausted or are contraindicated because of patient age, concomitant medical illness, multiple lesions or location of the lesion.

Lesions that are otherwise considered inoperable or inaccessible often can be treated successfully.

Previous external beam radiation therapy is not a contraindication. In fact, Gamma Knife is an excellent treatment for recurrent, previously irradiated brain metastases and primary brain tumors and appears promising as a boost therapy in newly diagnosed metastases.

It is also an excellent option for patients with acoustic neuromas in whom preservation of hearing and/or facial function is particularly desirable.

Patients with trigeminal neuralgia who do not respond to medical therapy, and for whom it is desirable to avoid invasive surgical procedures, are excellent candidates for Gamma Knife SRS. Similarly, patients with medically refractory tremor can benefit from radiosurgical thalamotomy.

Advantages
Gamma Knife SRS is a non-invasive, outpatient procedure which allows patients to return home in about half a day.

Patients can usually return to their normal routine within a day of the procedure. The majority of patients are treated on an outpatient basis and do not require hospitalization.

In addition to the other benefits, use of the Gamma Knife may be more cost-effective than conventional surgery. Also, many of the expenses of disability and prolonged convalescence associated with conventional surgery are avoided.

About Our Program
Our team of specialists is among the most experienced in the country. Since 1999 we have performed more than 600 Gamma Knife SRS procedures. In addition, Edward Shaw, M.D., chairman of the Department of Radiation Oncology and co-director of our Gamma Knife program, brings years of expertise to our institution, having established a similar program at the Mayo Clinic in 1990.

Research
Extensive research efforts are underway at WFUBMC as part of our Gamma Knife SRS program. Researchers intend to:

• Identify ways to more precisely treat targets in the brain that are close to critical brain structures (e.g. optic nerve/chiasm, brain stem and pituitary gland).
• Identify drugs that will sensitize cancerous brain tumor cells to the effects of radiation produced by the Gamma Knife and therefore improve the probability of curing the most malignant brain tumors.
• Collaborate with imaging scientists -- Positron Emission Tomography (PET), Magnetic Resonance Imaging (MRI) Spectroscopy, and Functional MRI – and Medical Center researchers to understand the mechanisms of radiation-induced brain injury; to better treat patients who develop brain injury from radiation therapy; and, to develop drugs which will prevent such injury.

Consultations and Patient Convenience
We make a concerted effort to ensure that every eligible patient is efficiently evaluated and treated. To accomplish this goal we arrange to see patients in consultation promptly. Alternatively, we are able to evaluate films, clinical history and, if appropriate, pathologic slides in our weekly Gamma Knife conference to determine if travel to Winston-Salem for a formal consultation is desirable or necessary.

The procedure is often most conveniently scheduled for the day following initial consultation, eliminating the need for two trips to the Medical Center. On the morning of the treatment, patients undergo head frame placement, neuroimaging and then treatment, all within the span of 4-8 hours.

Clinical imaging follow-up after radiosurgery can be arranged either with the referring physician in their community, or here at Wake Forest University Baptist Medical Center, whichever is more desirable and convenient for the patient.