Russian neurosurgical institute acquires Leksell Gamma Knife Perfexion system

Russia's first Leksell Gamma Knife® Perfexion™ system has found a home at the renowned N.N. Burdenko Neurosurgical Institute, just a five-minute car ride from Moscow's Red Square. On June 2, 2011, a 59-year-old woman was the first Perfexion patient, receiving Gamma Knife® radiosurgery to treat tumor tissue that remained following open surgery. Now, eight months later, the Institute has treated more than 400 patients on the system, half of them with one or more metastases, tumors for which Gamma Knife surgery is increasingly regarded as the preferred frontline treatment.

Gamma Knife surgery is a gentler alternative to traditional brain surgery for illnesses such as metastatic disease – cancer that has traveled to the brain from elsewhere in the body. The system precisely delivers up to thousands of low-intensity radiation beams to one or more targets in a single session.

Gamma Knife technology is not new to N.N. Burdenko clinicians – they had operated a Leksell Gamma Knife® C since 2005, treating a total of 1,812 patients, comprising 2,075 radiosurgery treatments over six years. Many of these patients received Gamma Knife surgery to treat multiple metastases, which often involved multiple treatment sessions or single sessions that could stretch to several hours.

"In the United States and European countries, there is some discussion about a threshold for the number of mets treated in a single session – three or four or more, but we've tried to treat all of them," says Andrey Golanov, M.D., Ph.D., Chief of the Department of Radiotherapy and Radiosurgery. "The most we've treated with our previous Gamma Knife is 32 mets in one session, but of course that took many hours. In the past, however, many patients with multiple mets had deposits located in different parts of the brain or had radioresistant mets. Both types of cases have required more than one session. Leksell Gamma Knife Perfexion has completely changed our approach to multiple metastases – we no longer have any limitations."

Perfexion dramatically streamlines the radiosurgery workflow and expands the treatable volume through an automated, multi-source collimator. The result has been faster set-up and treatment delivery to one or more tumors in a single session.

"Everything's easier with Perfexion, and that makes it easier for both patients and staff," Dr. Golanov says. "There's the potential for more indications, it's easier to plan and treat and the dose planning is superior with higher conformity. This is particularly evident in treating patients with multiple mets. For example, just yesterday we treated a patient with five metastases in only one hour – and these were large lesions requiring more than one beam per tumor."

"In November 2011, Dr. Golanov won a prestigious radiotherapy award for best treatment of brain metastasis, using Perfexion," notes Nabil Elias Romanos, Vice President, Elekta Eastern Europe & Middle East. "This recognition by radiation oncology professionals of this system's applications and efficacy for brain metastasis is good news for patients and clinicians."

Single and multiple metastases represent 37 percent of Burdenko's Perfexion weekly volume of 15-20 patients, while classic Gamma Knife indications – a variety of benign and malignant vascular and functional targets – comprise the rest. Dr. Golanov notes that Perfexion also presents the potential to treat new indications.

"We're really happy to have Perfexion, no doubt," Dr. Golanov says. "Leksell Gamma Knife has been the gold standard for intracranial radiosurgery for years. Perfexion makes Gamma Knife surgery even more refined, precise and efficient."