Listen to the UVA Today Radio Show report on this story by Jane Ford:



May 28, 2010 — 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 treated  patients with radiation instead of a scalpel to eliminate deep-seated tumors without damaging surrounding healthy tissue. The non-invasive 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 U.Va. is offering the latest and most advanced technology in stereotactic radiosurgery, called Gamma Knife eXtend, which allows physicians to treat larger tumors, multiple tumors and tumors near sensitive structures like the brainstem, facial nerves or the optic nerve. U.Va.'s Lars Leskell Center for Gamma Knife Radiosurgery is the first in the United States and the second worldwide to offer the eXtend 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 Dr. Jason Sheehan, associate professor of neurosurgery and radiation oncology at the U.Va. School of Medicine. Sheehan, co-director of the Center for Gamma Knife Radiosurgery, conducted radiosurgery using the eXtend system in mid-January – the first stereotactic radiosurgery of this type in the nation. 

U.Va. 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 U.Va. Health System to train with Sheehan and other U.Va. 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 system is to afford a very comfortable and accurate way for the patient to get radiosurgery multiple times if needed," Sheehan said. "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."

"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 Dr. James Larner, professor and chair of radiation oncology at the U.Va. School of Medicine. "Alternately, other surgical or radiation therapy techniques at U.Va. may be more appropriate."

For information on the eXtend system, go to the U.Va. Gamma Knife website.