Clinical Outcomes of Gamma Knife Stereotactic Radiosurgery for Neurological Disease

Abstract

Stereotactic radiosurgery (SRS) is a form of radiation therapy that delivers a focused, highly conformal dose of radiation to a single intracranial volume, while minimizing damage to the adjacent nervous tissue. SRS ensures precise radiosurgical localization by immobilizing the patient’s skull in a specified fixed position and in turn precisely aiming a high dose of radiation at the neurological target. SRS can be delivered to the patient via 3 therapeutic devices: Gamma Knife (GK) radiosurgery, linear accelerator based treatment, and cyclotron-based proton beam. Published reports have not found statistically significant differences in terms of clinical outcomes when analyzing patients treated with either radiosurgical device. The GK is a cobal-60-based machine, with 201 separate 4 to 18 mm collimator openings that emits multiple gamma rays that converge on a target specified by computer planning. This thesis describes the clinical outcomes of patients treated with GK radiosurgery at the Gamma Knife of Spokane and Cancer Care Northwest for metastatic brain tumors, vestibular schwannomas, movement disorders, and trigeminal neuralgia. This thesis will not address specific treatment recommendations for other neurological disorders that may be treated using GK radiosurgery.