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January 28, 2011

UVA is first U.S. medical center to offer new Gamma Knife technology to treat head and neck cancers

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A powerful new tool available at the University of Virginia Health System offers treatment to patients with some of the most challenging cancers of the head and neck.

For more than 20 years, the University of Virginia Health System has provided patients treatment that uses radiation instead of a scalpel to eliminate deep-seated tumors without damaging surrounding healthy tissue. The noninvasive procedure, known as Gamma Knife stereotactic radiosurgery, takes less than an hour, involves significantly less pain and trauma and avoids many of the risks of open surgery.

Now UVA is offering the latest and most advanced technology in stereotactic radiosurgery, called Gamma Knife eXtend TM , which allows physicians to treat larger tumors, multiple tumors and tumors near sensitive structures like the brainstem, facial nerves or the optic nerve. UVA’s Lars Leskell Center for Gamma Knife Radiosurgery is the first in the United States and the second worldwide to offer the eXtend TM system.

“This technology expands our ability to treat patients with radiosurgery in ways we would not have thought possible five or 10 years ago,” said Jason Sheehan, MD, PhD, FACS, associate professor of neurosurgery and radiation oncology at the UVA School of Medicine. Sheehan, co-director of the Center for Gamma Knife Radiosurgery, conducted radiosurgery using the eXtend TM system in mid-January. This was the first stereotactic radiosurgery of this type in the nation.

UVA neurosurgeons and radiation oncologists are pioneers in this field and have used Gamma Knife technology on more than 7,000 patients. Specialists from around the world come to UVA Health System to train with Sheehan and other UVA physicians.

Gamma Knife technology uses Gamma rays to deliver an intense, highly focused dose of radiation to the area targeted for treatment.  The procedure is combined with sophisticated three-dimensional imaging, such as functional imaging MRI or PET scan, and computer-aided treatment planning. Neurosurgeons first scan the brain by MRI or CT to locate the tumor and then use the Gamma Knife to focus 192 radiation beams precisely on the target.

Patients remain awake throughout the procedure in a room equipped with video monitoring and two-way voice contact. A single procedure takes 15 to 40 minutes, enabling patients to go home the day of surgery. Patients can resume normal activities that same day.

The eXtend system’s relocatable frame permits extremely high accuracy and precision over multiple sessions. A customized mouthpiece and headrest stabilizes and positions the patient’s head comfortably. The mouthpiece and headrest are reapplied in each of the sessions to treat the entire area.

“The idea of the eXtend TM system is to afford a very comfortable and accurate way for the patient to get radiosurgery multiple times if needed. This is ideal for patients with tumors that are too big for conventional radiosurgery or for those with tumors that are too close to adjacent structures that you could not treat with traditional radiosurgery,” Sheehan said.

“While the eXtend system broadens the potential for stereotactic radiosurgery to treat patients, others who are not candidates for the eXtend system can often be treated with the traditional Gamma Knife Perfexion technology,” said James Larner, MD, professor and chair of radiation oncology at the UVA School of Medicine. “Alternately, other surgical or radiation therapy techniques at UVA may be more appropriate.”

Gamma Knife technology effectively treats tumors that arise in or spread to the brain, such as acoustic neuromas, meningiomas, astrocytomas and metastatic tumors. Conventional brain surgery with a scalpel exposes the brain to a number of risks that Gamma Knife helps avoid, such as:

Long hospital stays Lengthy rehabilitation Damage to healthy brain tissue Surgical complications such as hemorrhage, infection or cerebral spinal fluid leak General anesthesia dangers Other physical trauma and disruption of normal brain function

For more information on the eXtend TM system at the University of Virginia Health System, go to the UVA Gamma Knife Web site ( ).

For clinical information for practitioners, including how to make a referral, go to the UVA Physician Direct Web site ( ) or call UVA Physician Direct at (800) 552-3723 .

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