PITTSBURGH, Dec. 22 /PRNewswire/ -- On the morning of December 17, 2009, UPMC physicians used Gamma Knife® surgery to treat the center's 10,000th patient, an 81-year-old male with a tumor deep in his brainstem, a site where traditional surgery would have been impossible. Gamma Knife surgery is performed using Elekta's Leksell Gamma Knife system, which directs up to 201 pencil-thin beams of therapeutic radiation precisely on brain tumors and other targets in the head.
The 10,000th patient came to UPMC with worsening balance problems. A magnetic resonance imaging (MRI) scan of his brain revealed the small lesion, known as a metastasis -- a secondary tumor whose origin was a primary tumor located somewhere else in his body. The site of this patient's primary lesion was unclear, as are approximately 30 percent of cancers that go to the brain, said L. Dade Lunsford, M.D., Lars Leksell Professor and Distinguished Professor of Neurological Surgery at the University of Pittsburgh, and co-director, Center for Image-Guided Neurosurgery, UPMC.
"Because the patient had no known primary tumor, we performed a minimally invasive biopsy of the brain tumor during a procedure that began at 6:30 a.m. We confirmed that the lesion was a metastatic tumor requiring intervention," said Dr. Lunsford, who was the first clinician to use Leksell Gamma Knife in the United States. "At 9:30, we used our Leksell Gamma Knife® Perfexion(TM) system to deliver the radiosurgery, which took about 38 minutes."
The patient is in excellent condition, and went home after his biopsy followed by Gamma Knife surgery, UPMC officials reported.
UPMC treated its first case in 1987, a patient with an acoustic neuroma, a benign tumor of the nerve that connects the ear to the brain.
Since 1987, and particularly in the last 15 years, UPMC has used Leksell Gamma Knife to treat almost 4,000 patients who had one or more metastases. Although historically, clinicians have turned to Gamma Knife surgery when whole brain radiation therapy fails or if new tumors arise, this non-invasive technique is rapidly becoming the first treatment option, Dr. Lunsford noted.
"Where Gamma Knife surgery is available, I suspect more than 50 percent of patients will receive this therapy as the primary treatment for newly diagnosed cancer that has spread to the brain, to avoid the known long term cognitive decline associated with whole brain radiation," he said.
Advances in imaging technology, such as MRI, enable doctors to detect metastases at earlier stages of cancer evaluation, before the tumors become large and begin to cause symptoms. This development, coupled with Gamma Knife precision, has led to its increased use to treat brain metastases.
"With Gamma Knife, patients whose cancer has spread to the brain now have an excellent chance that the problem can be controlled," Dr. Lunsford observed. "Doing less invasive surgery is a way that we can definitely improve patient outcome. We reduce hospital stays, we reduce cost and we get patients back in the workforce faster."
More than 500,000 patients worldwide have had Gamma Knife surgery, with about 50,000 patients annually receiving the therapy.
UPMC program evolves with Gamma Knife technology advances
In 1987, UPMC acquired its first Leksell Gamma Knife system. Radiosurgery also is used to manage benign lesions, including acoustic neuromas, meningiomas and skull base tumors. In addition, Gamma Knife surgery has been used to eliminate arteriovenous malformations (AVM).
Since 1987, the number of patients receiving Gamma Knife surgery at UPMC has increased from 150 patients annually to between 650 and 700 patients per year using both of the two Gamma Knife units at the UPMC Center for Image Guided Neurosurgery. The UPMC Gamma Knife Center's staff now includes four neurosurgeons, three radiation oncologists and four medical physicists. The medical center's most recent advance was the 2007 acquisition of Leksell Gamma Knife Perfexion, the fifth generation and most sophisticated radiosurgery system on the market.
Note: Dr. Lunsford is a paid consultant to Elekta AB, the developer and manufacturer of Leksell Gamma Knife. He also is a stockholder of Elekta AB.
UPMC Gamma Knife Treatments 1987-2009 (approximate numbers) Metastases: 4,000 Acoustic neuromas: 1,500 Meningiomas: 1,500 Gliomas: 1,000 Trigeminal neuralgia: 1,000 Other: 1,000
Elekta is a human care company pioneering significant innovations and clinical solutions for treating cancer and brain disorders. The company develops sophisticated, state-of-the-art tools and treatment planning systems for radiation therapy and radiosurgery, as well as workflow enhancing software systems across the spectrum of cancer care.
Stretching the boundaries of science and technology, providing intelligent and resource-efficient solutions that offer confidence to both healthcare providers and patients, Elekta aims to improve, prolong and even save patient lives, making the future possible today.
Today, Elekta solutions in oncology and neurosurgery are used in over 5,000 hospitals globally, and every day more than 100,000 patients receive diagnosis, treatment or follow-up with the help of a solution from the Elekta Group.
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