WASHINGTON, DC-Stereotactic radiotherapy of the skull base and head and neck is increasingly gaining favor as an attractive alternative to conventional surgery. The technique has the advantages of being noninvasive and the ability to accurately deliver doses of radiation to a target-killing dividing cells, damaging the DNA of cells leading to apoptosis, and reducing the blood supply to tumors, limiting their growth. A panel of experts discussed current experience with stereotactic modalities in otolaryngology practices as well as potential uses. Panelists agreed that optimal candidates still need to be defined for these procedures, but that this treatment option provides an opportunity for participation and leadership among otolaryngologists.
Explore this issue:January 2008
The Gamma Knife® is being used at select institutions to treat the following lesions: vestibular schwannomas (acoustic neuromas), other schwannomas or neuromas, meningiomas, head and neck malignancies, and paragangliomas (glomus jugulare tumors), said P. Ashley Wackym, MD, John C. Koss Professor and Chairman of the Department of Otolaryngology and Communication Sciences at the Medical College of Wisconsin in Milwaukee.
This method relies on fixation of a rigid metal frame to the patient’s head using local or general anesthesia. Imaging of the operative field with magnetic resonance (MR) or MR and CT is performed and images are sent to the GammaKnife computer workstation. Treatment of the tumor occurs in the three-dimensional area of the tumor, using spheres of various diameters of radiation designed to conform to the target. Dr. Wackym said the new Gamma Knife Perfexion® now allows treatment of lesions down to the level of the clavicle.