World neurosurgery leaders gathered in Amsterdam May 15-19 for the 18th International Leksell Gamma Knife Society Meeting. The annual conference is dedicated to Gamma Knife surgery in the treatment of intracranial disorders, and covers topics such as radiosurgery, benign tumors, vascular disorders, 
malignant tumors, ophthalmological disorders, functional disorders, radiobiology, physics, quality assurance, and imaging.
At the meeting, Elekta Instrument AB of Stockholm, Sweden, announced that its Leksell Gamma Knife has now been used in treatment of more than 1 million patients worldwide. Elekta is the developer and manufacturer of Gamma Knife tools and treatment planning systems for radiation therapy, radiosurgery, and brachytherapy,
From its first use in the late 1960s, with approximately 75,000 patients treated annually worldwide, Gamma Knife has become one of the most comprehensively studied radiosurgery platforms, with more than 2,800 peer-reviewed journal articles published to date.
Gamma Knife surgery, also sometimes referred to as stereotactic radiosurgery (SRS), is a non-invasive alternative to traditional brain surgery and radiation therapy for treatment of complex, difficult to treat brain conditions.
SRS delivers a single, high dose of irradiation to affected tissue through the intact skull, and is a treatment option favored for its precise accuracy, efficiency and outstanding therapeutic response. The stereotactic radiosurgery technique, together with Leksell Gamma Knife, was invented by the late Prof. Lars Leksell (1907-1986), a Swedish physician and professor of neurosurgery at the Karolinska Institute in Stockholm, Sweden.
Elekta notes that Gamma Knife surgery is now performed in hundreds of hospitals and clinics around the world, and building an impressive scientific track record reported in thousands of peer-reviewed articles. The company said no other non-invasive treatment method in this field has achieved greater clinical acceptance.
Average clinical volume per Gamma Knife surgery treatment site has also steadily grown due to an increasing volume of supporting clinical evidence as well as product enhancements that improve the method’s clinical efficiency.
“Gamma Knife stereotactic radiosurgery has evolved from a truly disruptive technological innovation to a mainstay of modern radiation surgery and neurosurgery and it has become the most clinically proven and comprehensively studied stereotactic radiosurgery platform in history,” said Dr. Laurent Leksell, Elekta’s founder and chairman of the board. “We are grateful to the dedication and innovation demonstrated by our global clinical partners and collaborators who have been instrumental in helping us continue to improve Gamma Knife technology to better address the needs of brain tumor patients and clinicians.”
Leksell Gamma Knife Icon, the system’s newest generation, introduces a number of new innovations, such as integrated imaging and software to continuously control dose delivery. Icon introduces a broader take on precision. Integrated immobilization, workflow, and imaging technologies allows greater clinical flexibility and enhanced everyday efficiency for clinics.
Icon is currently in use treating patients in Europe, the U.S., and Asia. Elekta says Icon expands on the Gamma Knife’s proven capabilities while providing additional frameless flexibility for supporting both accurate single dose administration or fractionated multiple treatment sessions performed over time in order to treat larger tumor volumes, targets close to critical brain structures, and/or new or recurring brain metastases.
A unique integrated stereotactic Cone Beam CT is another new addition to Icon. Calibrated to the patient positioning system, Cone Beam CT determines stereotactic coordinates in 3D using boney anatomy. After co-registration of images from the CBCT and MR, the treatment plan adapts automatically to any correction in patient position. The unique dose delivery attributes of Leksell Gamma Knife enables the system to automatically adapt for patient rotation, shot by shot, without any mechanical movement. Online dose evaluation enables the clinician to compare distribution about to be delivered to the dose the physician planned to deliver, all done right at the Icon console and, if required, the plan can be quickly and easily adapted online.
Leksell Gamma Knife Icon is FDA-cleared and CE-marked, and Elekta reports that over the coming months, Icon installations are planned for several leading cancer centers in the U.S., including The University of Texas MD Anderson Cancer Center in Houston, Texas; the University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania; the University of Virginia Health System in Charlottesville, Virginia; as well as at the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital in Amsterdam, and the Centre Hospitalier Universitaire Vaudois in Lausanne, Switzerland.
Metastatic brain tumors and other neurological disorders negatively impact survival and quality of life in a large and growing patient population. Reportedly, more than 256,000 new cases of brain and other CNS tumors are diagnosed annually worldwide, and are the cause of an estimated 189,000 deaths.
“Gamma Knife radiosurgery is a proven approach that has helped us resolve complex brain lesions, vascular complications, and other neurological abnormalities, many of which were previously thought to be inoperable,” says Jean Regis, MD, neurosurgeon and Gamma Knife program director at the University Hospital La Timone in Marseilles, France, who has performed more than 16,000 Gamma Knife procedures.
University Hospital La Timone was the world’s first to treat patients with Leksell Gamma Knife Icon. “Over the past four decades, we’ve established a wide body of clinical evidence supporting Gamma Knife radiosurgery in the treatment of diverse brain and central nervous system pathologies,” Regis said, “and in my experience, this is an attractive option for patients and clinicians, enabling a significant reduction in radiation exposure to healthy tissue and a negligible post-procedural convalescence period where the typical patient can usually leave the hospital within an hour.”
Douglas Kondziolka, MD, a researcher and neurosurgeon at the NYU Langone Medical Center in New York City, who has performed many thousands of Gamma Knife procedures, said: “Gamma Knife radiosurgery is an excellent example of how evolving cancer care technologies are addressing growing demand for precision medicine, where treatments can be precisely tailored to an individual’s unique anatomy and biologic makeup while simultaneously helping to reduce the risk of damaging healthy tissue. As one of the most comprehensively studied tools in the neurosurgery armamentarium, we can confidently offer this treatment option as a minimally invasive alternative to traditional brain surgery or whole brain radiation therapy for properly selected patients.”
Using up to 192 precisely focused sources of radiation, Gamma Knife can be used to control both malignant and nonmalignant tumors, as well as for treating arteriovenous malformations, essential tremor and trigeminal neuralgia while limiting damage to healthy tissue. Gamma Knife surgery’s high degree of precision is achieved by using a three-dimensional system of coordinates to locate and treat small targets inside the patient’s head.
People diagnosed with brain tumors, vascular malformations, and functional disorders and their families can learn more about treatment options at http://gammaknife.com, where you can find interactive and educational resources featuring first-hand patient and physician experiences with Gamma Knife, and information to support informed decision-making about treatment options.
