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Stereotactic radiation of intracranial tumors

General

For stereotactic radiation treatment, high radiation doses can be delivered with great precision to intracranial target areas, without the surrounding normal brain tissue being irradiated above the tolerance limit. Often a single radiation fraction is used, or possibly a few. The radiation dose in focus is then so high that the tissue in the small high-dose volume will die.

There are multiple equally effective techniques for stereotactic radiation treatment:

  • Gamma Knife (radiation knife)
  • linear accelerator
  • CyberKnife   

A gamma knife is mostly used for small tumors. The treatment is started and completed during one hospital stay. Haukeland University Hospital is the only hospital in Norway with a Gamma Knife. The technique will not described further here.

At Oslo University Hospital, the Radium Hospital, radiation therapy is carried out with a linear accelerator. This technique can also be used for larger tumors. The treatment is given in the form of several smaller radiation doses distributed over a number of weeks or as a single fraction.

A CyberKnife is a form of stereotactic treatment for delivering radiotherapy in which a linear accelerator is operated by a robot. The type of radiation and effect are otherwise equal to a gamma knife and/or linear accelerator. This system, however, is currently not available in Norway.

Indications

  • Intracranial metastases (max. number, 2-3 metastases; max. diameter, approximately 3 cm)
  • Small (max. 3 cm in diameter) Schwannomas or meningiomas 
  • Residual tumors after earlier operations for pituitary gland tumors
  • Other benign tumors where operation involves risks

Goal

  • Destroying the cancer cells' DNA and destroying the cancer cell
  • Neutralize the intracranial cancer disease of intracranial metastases
  • Limit radiation strain on surrounding brain tissue

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