The past, present and future of Gamma Knife radiosurgery for brain tumors: the Pittsburgh experience

Abstract

Since Lars Leksell conceived of the Gamma Knife in the mid-20th century, it has become a fundamental strategy for managing intracranial tumors. The Gamma Knife harnesses around 200 focused beams of ionizing radiation that are directed stereotactically onto an intracranial target, destroying or inactivating it, all while sparing surrounding tissues. Today, a patient can have numerous intracranial tumors treated by radiosurgery in a minimally invasive fashion, during a single outpatient encounter, and return to usual activities the next day. Gamma Knife radiosurgery has found applications for nearly all intracranial tumors, either as a primary strategy or adjunctive therapy. In no area has Gamma Knife radiosurgery had a larger impact than in the treatment of brain metastases. In this article, we review the evolution of Gamma Knife radiosurgery, discuss current indications for the treatment of intracranial tumors and highlight how the future treatment of metastatic brain cancer may change.

Keywords::

• brain metastasis
• brain tumor
• Gamma Knife
• meningioma
• stereotactic radiosurgery
• vestibular schwannoma
• whole-brain radiation therapy

Financial & competing interests disclosure

LD Lunsford is a consultant for Elekta AB and stockholder in Elekta AB, Stockholm, Sweden. A Niranjan is a consultant for Elekta AB. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.