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Gamma Knife - Medical Experts

For which diseases is the treatment suitable?

With the Gamma Knife therapy, specialists in radiation oncology, neuro-oncology or radiosurgery treat diseases especially of the brain, such as brain tumors or vascular malformations. The treatment is considered very safe and is an option if the doctor cannot reach the area to be treated with conventional neurosurgery. Radiation is also indicated when patients are not stable enough for longer operations. As a patient, you can of course also choose the therapy yourself if you prefer less invasive techniques.

Gamma knife therapy is often used for the following diseases:

Brain tumor and brain metastases

Radiosurgical treatment is possible for both benign and malignant tumors. The gamma radiation destroys the DNA (genetic material) in the tumor cells, so that no further duplication and thus no further growth takes place. The tumor decreases in volume over time after radiation therapy. The goal here is often not the complete removal of the tumor, but rather the prevention of further growth.

Epiphyseal tumors

The epiphysis is a gland at the base of the brain that plays an important role in regulating hormones. Tumors of the epiphysis lead to metabolic disorders and decreased or increased hormone production. The shrinking of such tumors is possible with the Gamma Knife therapy.

Schwannomas

Schwannomas are benign growths that affect the auditory and balance nerves. Pressure on the nerve causes dizziness, hearing loss or tinnitus. The sensitivity of the face or the facial muscles are also often affected. The spread of such neuromas can be successfully stopped with Gamma Knife Therapy.

Malformations of the cerebral vessels

These are abnormal formations of the vessels (arteries and veins) in the brain, so-called cerebral vascular diseases. For example, additional connections between arteries and veins mean that smaller vessels are not adequately supplied with blood. Gamma Knife therapy destroys such vascular connections and restores normal blood flow.

Neuralgia

Trigeminal nerve neuralgia (trigeminal neuralgia) can affect one or both halves of the face. Those affected suffer from sharp pain in the forehead, cheek or jaw area. The irradiation gives patients relief within a few days to months.

Course of treatment

In order to stabilize the head during the treatment and to focus the individual rays precisely, the oncologist attaches one lightweight, stereotactic frame. This is attached with four pins under local anesthesia. General anesthesia is usually not required for treatment in adults. You will be given a mild sedative if you so choose. First then there is a X-ray control tumor or malformed vessels to plan radiosurgical treatment. This is either computed tomography (CT) or magnetic resonance imaging (MRI). If a contrast medium is required, it is injected through a venous catheter.

With the results of these investigations, calculate the Radiation oncologist the required radiation dose, determine the brain areas to be treated and the alignment of the individual rays. This is all computer-controlled and the doctor transmits the data directly to the radiation unit. The irradiation is carried out lying down. The patient drives into the radiation device on a couch or on a bed and the head frame connects to the device. The duration of treatment varies between one and five hours. If the duration is longer, the doctor will give infusions to stabilize the circulation.

During the procedure it is possible to communicate with the doctors via a microphone. The treatment is noiseless and painless.

Gamma Knife Therapy and Follow-Up Care

If headaches, nausea or vomiting occur immediately after radiation therapy, the doctor will treat them with appropriate medication. In addition, there may be slight bleeding where the head frame is attached. There are no restrictions on drinking or eating after the procedure. Otherwise, regular check-ups are necessary to evaluate the success of the treatment and the course of the disease.

Prognosis and Risks of Gamma Knife Therapy

Since Gamma Knife therapy is a non-invasive treatment method, the risks are lower than with open brain surgery. Side effects through the low dose radiationthat can occur immediately after treatment are generally temporary and go away after a few days to weeks. Common complaints include:

  • Nausea or vomiting
  • a headache
  • fatigue
  • An itchy sensation on the scalp
  • Swelling of the irradiated brain tissue
  • Swelling or redness of the scalp
  • Minor hair loss in the irradiated areas

In very rare cases, neurological symptoms are recorded as late effects.

The forecast Gamma Knife irradiation, as with other forms of therapy, depends on the underlying disease and the general health of the patient. As a rule, however, good results can be achieved with Gamma Knife Therapy. The volume of benign tumors shrinks within one to two years. Malignant tumors often decline more quickly. Gamma-ray occlusion of abnormal cerebral vessels also takes up to two years or more. The pain treatment for neuralgia shows results within a few months.

Conclusion

In the Gamma Knife Therapy it is a safe and precise method of radiation therapy currently used for brain tumors. Compared to open brain surgery, the risks are low. The gamma radiation is generated computer-controlled with a linear accelerator. The latest devices are saved as Cyberknife referred to and based on robotics. They can be used to irradiate tumors throughout the body. In Germany alone there are now over ten such systems in oncological centers.