Make An Appointment

Non-Invasive, Single Day Treatment

Most patients get treated within 2 weeks

Primary brain tumors

Why Gamma Knife treatment

The Gamma Knife produces over 200 precise beams of low-dose radiation that all focus and intersect directly on the tumor, killing the tumor, yet keeping normal healthy brain tissue safe.

The head is fixed in a frame that keeps the brain stable and secure, setting up a GPS-like coordinate system that allows the doctors to target the tumor with sub-millimeter precision. The surgeon numbs up the areas where the frame is placed (much like a dentist numbs the gums) so there is little discomfort. Other treatments that do not use a head frame simply are not as accurate, and therefore more normal brain tissue is at risk.

Also, unlike other forms of treatment, it will only take us one day to treat these tumors and get patients back to their medical oncologist.

For this reason, we recommend that lung cancer patients have an MRI of their brain immediately upon diagnosis, before beginning chemotherapy. It is possible to have metastatic brain tumors without having symptoms. Gamma Knife of Spokane can treat these brain tumors and systemic treatment of the lung cancer can start as soon as the next day. However, once chemotherapy has begun, Gamma Knife treatment must wait.

Why Gamma Knife of Spokane

You are in good hands at Gamma Knife of Spokane. As one of the top 10 Gamma Knife treatment centers in the country for the number of patients treated, no one in the region has more experience in treating brain tumors. No one. Over 60% of the patients we have treated at Gamma Knife of Spokane have come to us with brain metastases.

With Gamma Knife of Spokane, patients have access to a $5 million, 45,000 pound cancer-killing machine that can, in a few hours, deliver a dose of radiation that can stop the growth of most tumors or even eliminate tumors altogether.

In addition to our experience of over a decade treating patients, we have one of the most prolific clinical research departments in the country (7th of 130 centers). We are frequently asked to write book chapters for oncology textbooks. The national medical community considers us experts in the field of brain tumor research and treatment.

Clinical Outcomes of Gamma Knife Treatment

Description of Primary Tumor Types Here

Day of treatment

After 7 months

Tentorial Meningioma 7 Months After Treatment

The tumor was reduced from 25mm at the time of procedure to 18 mm at 7 months after the procedure.

Definitions

Brain tumors are tumors that grow in the brain. A tumor is an abnormal growth caused by cells reproducing themselves in an uncontrolled manner.

When doctors describe tumors in parts of the body other than the brain, they use the words benign (meaning harmless) or malignant (meaning cancerous). These meanings change, however, when referring to tumors in the brain.

Benign brain tumors
A benign brain tumor consists of benign (harmless) cells and has distinct boundaries. Surgery alone may cure this type of tumor.

Malignant brain tumors
A malignant brain tumor is life-threatening. It may be malignant because it consists of cancer cells, or it may be called malignant because of its location. In other words, a brain tumor composed of benign cells--but located in a vital area--is still considered malignant.

A malignant brain tumor made up of cancerous cells may spread or seed (metastasize) to other locations in the brain or spinal cord. It can invade and destroy healthy tissue so it cannot function properly. Malignant tumors grow the way a plant does, with "roots" invading various tissues. Or, they can shed cells that travel to distant parts of the brain. Some cancerous tumors, however, remain localized.

Malignant brain tumors seldom metastasize outside the brain and spinal cord. [Central Nervous System (CNS)]

The bones of the skull hide brain tumors. The doctor can not feel or see them during a routine examination. Scans produce pictures that suggest a particular type of tumor. Only a sample of tumor examined under a microscope can provide an exact diagnosis . If this type of examination is not possible, an educated assumption is made based on available test results.

Often, the damage done by brain tumors is due to their size. Because the skull is bone, it cannot expand to make room for even a small mass growing within it. As a result, the tumor presses on and displaces normal brain tissue. This pressure may damage or destroy delicate brain tissue. Many of the symptoms of a brain tumor are caused by this pressure. Sometimes, a tumor may cause blockage of fluid that flows around and through the brain. This blockage can also create increased pressure. Some brain tumors also cause swelling due to accumulation of fluid (edema). Size, pressure, and swelling all create this "mass effect."

Category
   Tumors that start in the brain are primary brain tumors.
   Metastatic brain tumors are tumors formed by cancer cells that start elsewhere in the body and spread to the brain.

Naming Tumors

Tumor names depend on where the tumor originated, its pattern of growth, and whether it is cancerous or not. The following are some general names of tumors:

Adenoma
A usually benign tumor arising from a gland; for example, pituitary adenoma.

Blastoma
A malignant tumor whose cells have undeveloped (embryonic) characteristics; for example, medulloblastoma or glioblastoma multiforme.

Carcinoma
A malignant tumor that arises from skin or the lining of the digestive, respiratory, and urogenital systems; for example, lung cancer (small cell carcinoma) or colon cancer (adenocarcinoma).

Sarcoma
A malignant tumor that arises from connective tissue, blood vessels, or the lymph system; for example, osteosarcoma.

Glioma
The general name for a tumor that arises from the supportive tissue of the brain; for example, astrocytoma or oligodendroglioma. It may be benign or malignant.

Some tumors may undergo further change (mutation). A benign growth may become malignant. In some tumors, a lower-grade tumor may recur as a higher-grade tumor.

Grading Tumors

Tumor grade indicates the degree of malignancy. Grade is based on the tumor's tendency to spread (infiltrate), its growth rate, and its similarity to normal cells.

Tumors with distinct borders (circumscribed), considered grade I, are sometimes referred to as benign or mildly malignant. Those tumors either do not grow or grow slowly.

Infiltrating tumors are those that tend to grow into surrounding tissue. Of the infiltrating tumors, the terms low-grade, mid-grade, and high-grade are frequently used. However, the exact system used to grade tumors varies with each specific family of tumors.

Tumors often contain several grades of cells. The highest or most malignant grade of cell found during microscopic examination determines the grade, even if most of the tumor is a lower grade.

CLINICAL RESEARCH

Gamma Knife Solution

Adjuvant gamma knife stereotactic radiosurgery at the time of tumor progression potentially improves survival for patients with glioblastoma multiforme.


Hsieh PC, Chandler JP, Bhangoo S, Panagiotopoulos K, Kalapurakal JA, Marymont MH, Cozzens JW, Levy RM, Salehi S.


Neurosurgery. 2005 Oct;57(4):684-92; discussion 684-92.


Department of Neurological Surgery, Northwestern University McGaw Medical Center, Chicago, Illinois, USA. phsieh@md.northwestern.edu


OBJECTIVE: Gamma knife stereotactic radiosurgery (GK-SRS) is a safe and noninvasive treatment used as adjuvant therapy for patients with glioblastoma multiforme (GBM). Several studies have yielded conflicting results in the effectiveness of radiosurgery in GBM. This study is a retrospective review of our institutional experience with GK-SRS adjuvant therapy in the treatment of GBM.

METHODS: From October 1998 to January 2003, 51 consecutive patients were treated with GK-SRS as an "upfront" adjuvant therapy after surgery or at the time of tumor progression at Northwestern Memorial Hospital. Survival analysis was performed using the Kaplan-Meier actuarial method. Univariate and multivariate analyses of patient characteristics and treatment variables were performed.

RESULTS: Treatment with adjuvant GK-SRS yielded a median overall survival of 14.3 months for our cohort. Survival rate of the cohort was 68% at 12 months, 30% at 24 months, and 24% at 36 months. Karnofsky performance score greater than 90 and adjuvant chemotherapy were associated with increased survival on multivariate analysis. Adjuvant GK-SRS performed at tumor progression seems to increase median survival to 16.7 months compared with 10 months when performed after the time of initial tumor resection. Median survival rates by recursive partitioning analysis class breakdown in our cohort are greater than those predicted by other studies.

CONCLUSION: GK-SRS is a relatively safe and noninvasive procedure that conferred an improvement in overall survival of GBM patients in our retrospective study. Particularly, GK-SRS may improve overall survival when performed at the time of tumor progression.

Long-Term Outcomes after Meningioma Radiosurgery: Physician and Patient Perspectives

Douglas Kondziolka, M.D., M.Sc., FRCS(C), Elad I. Levy, M.D., Ajay Niranjan, M.Ch., John C. Flickinger, M.D., L. Dade Lunsford, M.D.


Published in Journal of Neurosurgery 91:44-50,1999.


OBJECT: Stereotactic radiosurgery is a primary or adjuvant management approach to patients with intracranial meningiomas. The goal of radiosurgery is long-term prevention of tumor growth, maintenance of patient neurologic function, and prevention of new neurological deficits. The object of this study is to report longer-term patient outcomes.

METHODS: We evaluated 99 consecutive meningioma patients who underwent radiosurgery between 1987 and 1992 using serial imaging tests, clinical evaluations, and a patient survey between five and ten years later. Four patients had two radiosurgery procedures for separate meningiomas. The average tumor margin dose was 16 Gy and the median tumor volume was 4.7 ml (range, 0.24-24). Fifty-seven patients (57%) had prior resection of which 12 were considered "total". Five patients received fractionated radiation therapy before radiosurgery. Eighty-nine patients (89%) had skull base tumors.

RESULTS: The clinical tumor control rate (no resection required) was 93%. Sixty-one tumors were smaller (63%), 31 remained unchanged in size (32%), and 5 enlarged (5%). Resection was performed in 7 patients (7%), six of whom had prior resection. New neurological deficits developed in five patients (5%), 3 to 31 months after radiosurgery. Twenty-seven patients (42%) were employed at the time of radiosurgery and 20 (74%) remained so. Radiosurgery was believed "successful" by 67 of 70 patients who competed an outcomes questionnaire 5 to 10 ten years later. At least one complication was described by 9 patients (13%) and in four these resolved.

CONCLUSIONS: Five to ten years after radiosurgery, 96% of surveyed patients believed that radiosurgery provided a satisfactory outcome for their meningioma. Overall, 93% of patients required no other tumor surgery. Morbidity in this early experience was usually transitory, and relatively mild. Radiosurgery provided long-term tumor control associated with high rates of neurologic function preservation and patient satisfaction.

Gamma knife stereotactic radiosurgery for patients with glioblastoma multiforme.

Nwokedi EC, DiBiase SJ, Jabbour S, Herman J, Amin P, Chin LS.


PMID: 16239880 [PubMed - in process] Neurosurgery 2002 Jan;50(1):41-6; discussion 46-7


Department of Radiation Oncology, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201, USA.


OBJECTIVE: Stereotactic radiosurgery (SRS) has become an effective therapeutic modality for the treatment of patients with glioblastoma multiforme (GBM). This retrospective review evaluates the impact of SRS delivered on a gamma knife (GK) unit as an adjuvant therapy in the management of patients with GBM.

METHODS: Between August 1993 and December 1998, 82 patients with pathologically confirmed GBM received external beam radiotherapy (EBRT) at the University of Maryland Medical Center. Of these 82 patients, 64 with a minimum follow-up duration of at least 1 month are the focus of this analysis. Of the 64 assessable patients, 33 patients were treated with EBRT alone (Group 1), and 31 patients received both EBRT plus a GK-SRS boost (Group 2). GK-SRS was administered to most patients within 6 weeks of the completion of EBRT. The median EBRT dose was 59.7 Gy (range, 28-070.2 Gy), and the median GK-SRS dose to the prescription volume was 17.1 Gy (range, 10-28 Gy). The median age of the study population was 50.4 years, and the median pretreatment Karnofsky performance status was 80. Patient-, tumor-, and treatment-related variables were analyzed by Cox regression analysis, and survival curves were generated by the Kaplan-Meier product limit.

RESULTS: Median overall survival for the entire cohort was 16 months, and the actuarial survival rate at 1, 2, and 3 years were 67, 40, and 26%, respectively. When comparing age, Karnofsky performance status, extent of resection, and tumor volume, no statistical differences where discovered between Group 1 versus Group 2. When comparing the overall survival of Group 1 versus Group 2, the median survival was 13 months versus 25 months, respectively (P = 0.034). Age, Karnofsky performance status, and the addition of GK-SRS were all found to be significant predictors of overall survival via Cox regression analysis. No acute Grade 3 or Grade 4 toxicity was encountered.

CONCLUSION: The addition of a GK-SRS boost in conjunction with surgery and EBRT significantly improved the overall survival time in this retrospective series of patients with GBM. A prospective, randomized validation of the benefit of SRS awaits the results of the recently completed Radiation Therapy Oncology Group's trial RTOG 93-05.

Long-Term Outcomes after Meningioma Radiosurgery: Physician and Patient Perspectives

Douglas Kondziolka, M.D., M.Sc., FRCS(C), Elad I. Levy, M.D., Ajay Niranjan, M.Ch., John C. Flickinger, M.D., L. Dade Lunsford, M.D.


Journal of Neurosurgery 91:44-50,1999.


Object: Stereotactic radiosurgery is a primary or adjuvant management approach to patients with intracranial meningiomas. The goal of radiosurgery is long-term prevention of tumor growth, maintenance of patient neurologic function, and prevention of new neurological deficits. The object of this study is to report longer-term patient outcomes.

Methods: We evaluated 99 consecutive meningioma patients who underwent radiosurgery between 1987 and 1992 using serial imaging tests, clinical evaluations, and a patient survey between five and ten years later. Four patients had two radiosurgery procedures for separate meningiomas. The average tumor margin dose was 16 Gy and the median tumor volume was 4.7 ml (range, 0.24-24). Fifty-seven patients (57%) had prior resection of which 12 were considered "total". Five patients received fractionated radiation therapy before radiosurgery. Eighty-nine patients (89%) had skull base tumors.

Results: The clinical tumor control rate (no resection required) was 93%. Sixty-one tumors were smaller (63%), 31 remained unchanged in size (32%), and 5 enlarged (5%). Resection was performed in 7 patients (7%), six of whom had prior resection. New neurological deficits developed in five patients (5%), 3 to 31 months after radiosurgery. Twenty-seven patients (42%) were employed at the time of radiosurgery and 20 (74%) remained so. Radiosurgery was believed "successful" by 67 of 70 patients who competed an outcomes questionnaire 5 to 10 ten years later. At least one complication was described by 9 patients (13%) and in four these resolved.

Conclusions: Five to ten years after radiosurgery, 96% of surveyed patients believed that radiosurgery provided a satisfactory outcome for their meningioma. Overall, 93% of patients required no other tumor surgery. Morbidity in this early experience was usually transitory, and relatively mild. Radiosurgery provided long-term tumor control associated with high rates of neurologic function preservation and patient satisfaction.

Peer-reviewed Journals

Effect of pretreatment clinical factors on overall survival in glioblastoma multiforme: a Surveillance Epidemiology and End Results (SEER) population analysis. Thumma SR, Fairbanks RK, Lamoreaux WT, Mackay AR, Demakas JJ, Cooke BS, Elaimy AL, Hanson PW, Lee CM. World J Surg Oncol. 2012 May 3;10:75. doi: 10.1186/1477-7819-10-75. View PDF
Long-term survival after gamma knife radiosurgery in a case of recurrent glioblastoma multiforme: a case report and review of the literature. Thumma SR, Elaimy AL, Daines N, Mackay AR, Lamoreaux WT, Fairbanks RK, Demakas JJ, Cooke BS, Lee CM. Case Rep Med. 2012;2012:545492. doi: 10.1155/2012/545492. Epub 2012 Apr 4. View PDF
Olfactory neuroblastoma treated by endoscopic surgery followed by combined external beam radiation and gamma knife for optic nerve and chiasm sparing: a case report. Jiang HZ, Elaimy AL, Jones GC, Mackay AR, Fairbanks RK, Lamoreaux WT, Demakas JJ, Cooke BS, Lee CM. Case Report Med. 2011;2011:765645. doi: 10.1155/2011/765645. Epub 2011 Nov 9. View PDF
Olfactory neuroblastoma treated by endoscopic surgery followed by combined external beam radiation and gamma knife for optic nerve and chiasm sparing: a case report. Jiang HZ, Elaimy AL, Jones GC, Mackay AR, Fairbanks RK, Lamoreaux WT, Demakas JJ, Cooke BS, Lee CM. In press.
Long term survival after gamma knife radiosurgery in a case of recurrent glioblastoma multiforme: a case report and review of the literature. Thumma SR, Mackay AR, Lamoreaux WT, Fairbanks RK, Demakas JJ, Cooke BS, Elaimy AL, Lee CM. In press. Invited Textbook Chapters

The content of this web site is for informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider. If you have a medical problem or a health-related question, consult your physician or call our center at 509.473.3800 for an appointment with one of our neurosurgeons.

Gamma Knife: The best solution

Caring with precision

Treating brain tumors and other conditions in the brain requires absolute precision, because every bit of healthy tissue helps make you who you are. And nothing provides more precision than Gamma Knife stereotactic radiosurgery, especially in the hands of a caring, superbly skilled and experienced team of neurosurgeons and radiation oncologists.

In fact, Gamma Knife of Spokane ranks in the top 10 Gamma Knife Centers in the U.S. for published clinical research and patient volumes.

It's YOUR brain. Call us at 1.800.927.5051 and we can help you determine whether Gamma Knife treatment is a helpful option for you.

Let us help you get on with living.

FAQS

CONTACT US

info@gkspokane.com

Call  Our  Center
at 1-800-927-5051

Caring with Precision

©2017 GAMMA KNIFE SPOKANE, USA. All Rights Reserved.