Stereotactic radiosurgery – Cyber ​​Knife – Gamma Knife treatment

Description of Gamma Knife treatment

Stereotactic radiosurgery is a method for treating brain disorders. This therapy uses highly focused beam of radiation to treat specific areas of the brain. The beam of radiation destroys the tissue, that the traditional method of treatment, the doctor removes a scalpel during surgery.

The treatment is performed by a team of specialists, including:

• Radiation Oncology – develops a treatment plan and provides defines the required dose of radiation;
• Neurosurgeon – examines the patient's brain, and also helps in planning;
• Medical Physicist – It helps the oncologist to determine the radiation dose, It controls the radiation-emitting device (Gamma Knife or a linear accelerator);
• Physicists – determines the radiation dose received by the patient;
• Radiation Therapist – It is working with radiating device;
• Nurse Oncology – directly caring for patients;
• A neurologist or neurosurgeon neurooncology – It is helping radiation oncology in the treatment of brain tumors, including control during rehabilitation of the patient, It may also coordinate overall treatment plan.

The reasons for the treatment of Gamma Knife

Radiosurgery is used for the following purposes:

• The destruction of cancerous and benign tumors;
• Stopping the development of cancer and benign tumors;
• Close arteriovenous malformations (AVM), abnormal blood vessels, that break the flow of blood to the brain;
• Treating disorders, such as:
  • Neuralgia nerve troynichnogo, causing facial pain;
  • Epilepsy – disorder, which causes seizures.

Possible complications of stereotactic radiosurgery

Before, how to perform the operation, you need to know about possible complications, which may include:

• Headache;
• Temporary swelling at the treatment site (may be worsening symptoms);
• Edema, numbness, bleeding, or tingling in the junction of the head with the neck;
• Skin irritation;
• Nausea;
• Convulsions;
• Small hair loss from radiation;
• The presence of permanent injury to the brain in the treatment.

Rare complications may include:

• Loss of sight;
• Deafness;
• Bleeding;
• Nerve problems.

Despite, the risk of complications is low, advanced age, chronic diseases, previous operations, or previous radiation therapy near the site of the planned operation may increase the risk of complications.

How we treat?

Preparation for the procedure

Your doctor may do the following:

• Perform neurological examination, to see, how good is your nervous system functions;
• Order x-rays, CT scan of the head, MRI or other diagnostic tests;
• Order additional tests if necessary.

Doctors also need to know the following:

• Taking any medications or insulin to control diabetes;
• If you have an allergy to intravenous contrast agent – substance, which makes it easier to see the tumor, you need to report it;
• We need to tell the doctor about allergy to iodine or shellfish (Iodine is present in shellfish and contrast material);
• You need to tell your doctor about the availability of a pacemaker or other medical devices, implanted into the body;
• If you have the implant in the eye or ear, you need to report it;
• Reported previous operations;
• If ever there were a skull injury, I have to say about it;
• If you suffer from claustrophobia, you need to tell your doctor;

In the run-up to the procedure:

• You may be asked to stop taking certain medications;
• We must organize the following:
  • Help before treatment;
  • The trip home after treatment;
  • Care after the procedure;
• As directed by the doctor need to use a special shampoo.

The day before the procedure,:

• Do not use any creams or hair spray;
• Do not eat or drink anything after midnight, unless otherwise noted physician.

On the day of the procedure:

• Grab the medications taken to hospital;
• Do not wear jewelry, wig or hairpiece, Do not use make-up;
• Remove contact lenses, glasses, dentures;
• A hand is inserted cannula, for the administration of contrast medium, drugs and fluids.

Procedure stereotactic radiosurgery

There are several types of treatment:

Treatment with a Cobalt-60 (commonly called Gamma Knife)

The procedure is performed using 201 beam directed gamma rays. It is used to treat brain tumors and functional disorders of the brain. Gamma Knife is the most well-known device for this procedure.

Treatment takes place in four phases:

1. Training head – Local anesthesia will be injected into the front and back of the head, to numb the skin. Special aluminum frame will be attached to the skull with special pins. This will keep your head from moving during treatment.
2. Photographing head – performed Head CT and / or MRT, to determine the exact location of a tumor. If untreated arteriovenous malformations, you can go angiografiyu, to find abnormal veins.
3. Planning Phase – Based on analysis of the doctors plan treatment. When they are finished, You put on a special couch. Your doctor will tell you, How will the procedure, and planned dose. At the head is put on a helmet with a lot of small holes. Each opening can direct a radiation beam to a specific part of the brain;
4. Radiation. Doctors and nurses will leave the room. The couch is located in the area of ​​radiation. Helmet closes, then begins immediately self exposure. The doctor will be able to see and hear you during the entire procedure, and you will also be able to talk to him. Radiated, used for the treatment can not be seen, feel or hear. When the treatment session is over, doctors go to the office, take off the helmet and head free.

Treatment with the help of a linear accelerator

This procedure uses a powerful beam of radiation. It is used to treat small and large brain tumors. You'll pass through phases, above. During irradiation, However, radiation source will move around you. Modern systems can also handle radiation tumor of spinal cord.

Treatment Of Cyber-Knife

Cyber Knife treatment is carried out using a small linear accelerator, mounted on a robotic manipulator. It is used to treat tumors and lesions of the brain and spinal cord. In this case, the head is not fixed in a frame.

Treatment takes place in three stages:

1. Preparation – If you are being treated for brain tumor, put a special mask, that will fit your head. Is also computed tomography, and, perhaps, MRT. If you are treating cancer of the spinal cord, the patient sit in a special chair. Near tumors implanted small metal markers, called coordinate (Fiducials), to guide a beam of radiation during treatment. Coordinate markers implanted in an outpatient setting. After, as they are in place, runs computer tomography;
2. Treatment planning. You may be allowed to return home during breaks between courses of treatment. In fact, the treatment can be performed on the same day or a few days after the preparation phase;
3. Radiation. The head wears a mask, or the patient is placed in a Chair, and then placed on the table. Before starting treatment with x-rays will be conducted, to orient a linear accelerator in the correct position. After the start of treatment, the manipulator will move around you, stopping at fixed points. When the manipulator stops, irradiation of tumour.

After the procedure

If you have used a gamma knife treatment and linear accelerator:

• The head is released from clamps, intravenous catheter extracted;
• Superimposed on the head of a small bandage.

How long will the treatment take?

Radiation exposure to the Gamma Knife and linear accelerator may take up to 2 hours. Treatment can take up to KiberNozhom 3 hours.

The entire procedure usually takes 2-4 o'clock.

Will it hurt?

• Anesthesia prevents pain at the site of catheter, If the process uses maintenance radiopaque;
• You will feel some pressure when you pin head stationary;
• The treatment itself causes no pain;
• You may experience headaches or nausea, a few hours after treatment. The doctor will give you medicine, to relieve discomfort.

Care after Stereotactic radiosurgery

When you return home after the procedure, follow these steps:, to ensure the normal recovery:

• You can return to daily activities on the day following the procedure;
• You can start taking medication, unless otherwise noted physician;
• Consult your doctor about the possibility of carrying out hard work;
• For about a week to avoid damp places catheter;
• Be sure to follow your doctor's instructions.

Results of Stereotactic radiosurgery can be seen over time – from a few months to several years.

• About a month after the procedure, a doctor conducts a Visual inspection and performs a neurological examination;
• Sometime after the evaluation procedure for therapeutic effect will be performed MRI scan or CT scan;
• If you were treated arteriovenous malformations, cerebral angiography is performed every two to three years after treatment, to determine the effectiveness of treatment;
• In many cases, the procedure of Stereotactic radiosurgery can be performed again, if necessary.

Communication with a physician after Stereotactic radiosurgery

After returning home, you need to see a doctor, If the following symptoms:

• Signs of infection, including fever and chills;
• Redness, edema, increased pain, bleeding, or any discharge from the catheter sites;
• Nausea and / or vomiting, which do not disappear after taking the prescribed medicines, and persist for more than two days after discharge from the hospital;
• Pain, which does not pass after taking pain medication appointed;
• Cough, breathlessness, cardiopalmus, or chest pain;
• Strong headache;
• Weakness, disequilibrium;
• Vision problems;
• Convulsions;
• Any new symptoms, including bouts of insensitivity.