Download PDF
CC BY 4.0 · Indian Journal of Neurosurgery
DOI: 10.1055/s-0044-1782666
Research Article

First Thousand Cases of Intracranial Radiosurgery Treated with Gamma Knife at a Tertiary Care Hospital in India

M.S. Sridhar 
1   Department of Neurosurgery, Gammaknife Surgery Centre, Army Hospital (R&R), Delhi Cantonment, New Delhi, India
,
Arti Sarin
1   Department of Neurosurgery, Gammaknife Surgery Centre, Army Hospital (R&R), Delhi Cantonment, New Delhi, India
,
H.S. Bhatoe
3   Department of Neurosurgery, Max Super Specialty Hospital, Mohali, Punjab, India
,
Harish C. Pathak
4   Department of Neurosurgery, Max Hospital, Dehradun, Uttarakhand, India
,
Manish Sharma 
5   Department of Neurosurgery, Command Hospital (SC), Pune, Maharashtra, India
,
Maneet Gill
1   Department of Neurosurgery, Gammaknife Surgery Centre, Army Hospital (R&R), Delhi Cantonment, New Delhi, India
,
Saurabh K. Verma
6   Department of Neurosurgery, Apollomedics Super Specialty Hospitals, Lucknow, Uttar Pradesh, India
,
Raj Ratan
1   Department of Neurosurgery, Gammaknife Surgery Centre, Army Hospital (R&R), Delhi Cantonment, New Delhi, India
,
Nilotpal Chakravarty
7   Department of Radiation Oncology, Yashoda Hospital & Research Centre, Ghaziabad, Uttar Pradesh, India
,
Manoj K. Semwal 
1   Department of Neurosurgery, Gammaknife Surgery Centre, Army Hospital (R&R), Delhi Cantonment, New Delhi, India
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Purpose We present the profile of first 1,000 cases of intracranial radiosurgery (IRS) treated with Gamma Knife system at a government-funded tertiary care hospital in India. In addition to the information on the indications treated, this study provides an idea of the relevance of the Gamma Knife Radiosurgery (GKRS) for IRS in the fast-changing technological scenario. This study also shows the disease indications for which GKRS was the primary treatment preference.

Materials and Methods Leksell Gamma Knife model 4C was used for GKRS. Leksell G-frame-based stereotactic localization was used for all patients. Axial magnetic resonance imaging scans were used for treatment planning with additional two-dimensional angiography images for patients treated for arteriovenus malformations (AVM). The patient population treated with GKRS at our center mainly comprised of patients referred from across the country.

Results Acoustic schwannoma formed the largest group of patients (27%) followed by meningioma (21%), AVM (18%), pituitary adenoma (16%), brain metastasis (5.3%), trigeminal neuralgia (3%), cavernoma (2.4%), glomus jugulare (1.8%), craniopharyngioma (1.1%) and “others” (5%).

Conclusion The case mix at our center is similar to the overall Indian case mix. However, it is different from the Asian data of 2018 but interestingly similar to the data from Middle East and Africa for 2018. Among the various categories of cranial disorders treated by us, pituitary adenoma tumors had minimum (14/161) and cavernoma tumors had maximum (24/24) proportion of cases managed with GKRS as primary treatment modality.

Keywords

case mix - Gamma Knife - intracranial disorders - stereotactic radiosurgery


Publication History

Article published online:
16 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Niranjan A, Lunsford LD. Radiosurgery: where we were, are, and may be in the third millennium. Neurosurgery 2000; 46 (03) 531-543
    CrossrefPubMedGoogle Scholar
  • 2 Leksell Gamma Knife Society. Treatment Statistics Report, 1968–2018. Stockholm: Leksell Gamma Knife Society; 2019
    Google Scholar
  • 3 Niranjan A, Maitz AH, Lunsford A. et al. Radiosurgery Techniques and Current Devices. In: Szeifert GT, Kondziolka D. Levivier M and Lunsford LD, eds. Radiosurgery and Pathological Fundamentals. Basel, Switzerland: Karger AG; 2007: 50-67
    Google Scholar
  • 4 Hamilton T, Dade Lunsford L. Worldwide variance in the potential utilization of Gamma Knife radiosurgery. J Neurosurg 2016; 125 (1, Suppl 1): 160-165
    CrossrefPubMedGoogle Scholar
  • 5 Bir SC, Ward T, Bollam P, Nanda A. First 1,000 cases of Gamma Knife surgery for various intracranial disorders in LSU Health-Shreveport: radiological and clinical outcome. J La State Med Soc 2015; 167 (02) 54-65
    PubMedGoogle Scholar
  • 6 Otto S. History and present status of gamma knife radiosurgery in Japan. Prog Neurol Surg 2009; 22: 1-10
    PubMedGoogle Scholar
  • 7 Pollock BE, Kline RW, Stafford SL, Foote RL, Schomberg PJ. The rationale and technique of staged-volume arteriovenous malformation radiosurgery. Int J Radiat Oncol Biol Phys 2000; 48 (03) 817-824
    CrossrefPubMedGoogle Scholar
  • 8 University of Pittsburgh Neurosurgery News. The Evolution of Gammaknife at UPMC. Peter C. Gerszten, editor.2016. Vol 17(1):1–7. Accessed February 21, 2024 at: www.neurosurgery.pitt.edu
    PubMed
  • 9 Boari N, Bailo M, Gagliardi F. et al. Gamma Knife radiosurgery for vestibular schwannoma: clinical results at long-term follow-up in a series of 379 patients. J Neurosurg 2014; 121 (Suppl): 123-142
    CrossrefPubMedGoogle Scholar