Spinal Neurinoma — Radiosurgery (Gamma Knife): treatment in the Best Hospitals in the World
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Gamma Knife and Radiotherapy Center
The Gamma Knife and Radiotherapy Center specializes in the stereotactic radiosurgical treatment and stereotactic radiotherapy for benign and malignant tumors of the head and neck, vascular malformations, as well as metastases in various organs (for example, in the liver, lungs, spine). The center has state-of-the-art equipment for stereotactic radiosurgery and stereotactic radiation therapy – Perfexion Gamma Knife and Axesse Linear Accelerator. The center also has innovative technologies of targeted radiotherapy, thanks to which healthy tissues can be completely removed from the radiation zone. At the same time, tumors and their metastases can be removed with an accuracy of up to 0,3 mm.
Gamma Knife Center
The Gamma Knife Center specializes in cancer treatment. The medical facility was founded in July 1998 and currently has the status of one of the most respected and experienced in the field of its specialization. The patients are treated in close collaboration with experts in neurosurgery and nuclear medicine. For all the years of their clinical practice, the center's doctors have cured thousands of patients with cancer pathologies of varying severity.
Gamma Knife and Radiotherapy Center
The Gamma Knife and Radiotherapy Center offers the full range of medical services in its field of competence. The treatment begins with an individual consultation and the comprehensive diagnostics, while the therapy is followed by all the necessary measures for follow-up care and consolidation of the result. The irradiation is carried out using the innovative Gamma Knife ICON, the characteristics of which ensure the successful removal of tumors up to 3 cm in size without damaging the surrounding healthy tissues. The highly qualified doctors of the center have many years of clinical experience and excellent skills in using this progressive system, so the patient can be sure that he will get the optimal result.
A neurinoma, along with a meningioma, is one of the most common spinal cord tumors. It grows from the spinal nerve sheaths. The tumor is benign and grows very slowly, but it still causes symptoms, including neurological disorders. As a rule, a microsurgical resection is performed for the treatment of spinal cord neurinomas. If surgery is contraindicated or if the spinal cord tumor recurs after its initial treatment, the neoplasm can be destroyed by radiation. Foreign hospitals use the Gamma Knife radiosurgery unit, which is highly accurate and allows the required dose of radiation to be delivered to the tumor in a single procedure. On the Booking Health website, you can select a hospital for your Gamma Knife treatment, find out prices, and make an appointment for your spinal neurinoma treatment abroad.
Content
- Who may need radiation therapy for spinal neurinomas?
- Principle of the treatment method for spinal neurinomas
- How safe is Gamma Knife radiation therapy for spinal neurinomas?
- Benefits of Gamma Knife treatment for spinal neurinomas
- Where to undergo your Gamma Knife treatment for spinal neurinomas?
Who may need radiation therapy for spinal neurinomas?
Patients with spinal neurinomas do not always complain about their health. Sometimes the tumor can be small and detected by chance when a patient has a CT scan or an MRI of the spine for another pathology. In such a situation, the patient does not require either surgical treatment or radiation therapy. All that is needed is monitoring. If the tumor begins to grow rapidly or causes any symptoms, treatment will be provided.
A microsurgical removal is considered to be the main treatment for spinal neurinomas. Doctors usually manage to perform a complete tumor resection as it does not invade normal spinal cord tissue and has clear boundaries. However, the operation to remove the tumor is traumatic, and some patients have contraindications for it due to the presence of concomitant somatic diseases. In such a situation, the Gamma Knife can be used as a primary treatment method since radiosurgery using this unit allows doctors to destroy the neoplasm with a minimal risk of repeated growth.
Below are the main indications for the treatment of neurinomas with the Gamma Knife:
- primary treatment of patients with contraindications to surgery;
- treatment of neurinomas that do not cause any symptoms or have minimal clinical manifestations;
- neuroma recurrence after its removal;
- residual tumor after surgery that increases in size during dynamic monitoring.
Principle of the treatment method for spinal neurinomas
The Gamma Knife is one of the stereotactic systems for radiosurgery and radiotherapy that allows doctors to deliver radiation to the tumor from many different directions. This is far from the only device of its kind. Many hospitals use CyberKnife (Accuray, Inc.), Synergy S (Elekta), or TrueBeam (Varian Medical Systems).
The Gamma Knife method of spinal neurinoma treatment is called stereotactic body radiation therapy (SBRT). The term "radiosurgery" is not common because it is used for brain tumor treatment.
SBRT involves the precise delivery of a large dose of radiation from many different directions to the tumor. As a result, healthy tissues are also irradiated, including the spinal cord, but each area receives a minimum dose of radiation that does not cause any complications. At the same time, the tumor receives a large dose of radiation because the rays that come from different directions converge on it. This is how doctors destroy a neuroma in a minimum number of sessions with low toxicity to the patient's body and with a minimal risk of post-radiation complications.
Depending on the size of the neurinoma and its location, radiation therapy with the Gamma Knife can be performed in 1-5 sessions. When treating small tumors with clear boundaries, if there is no risk of damage to the adjacent functionally important areas, doctors can destroy the neurinoma in one procedure. This treatment option is often referred to as "radiosurgery". It has little in common with a real surgical procedure because the tissues of the spine and spinal cord are not dissected. The term "radiosurgery" only demonstrates that all treatment objectives are achieved at one time.
Sometimes several procedures may be required. For example, if the neurinoma is large or it is difficult for doctors to completely destroy it without damaging nearby tissues of the spinal cord or spinal nerve roots.
How safe is Gamma Knife radiation therapy for spinal neurinomas?
The outdated methods of radiation therapy often cause post-radiation complications. With modern radiosurgical units, however, this is a rare case. In addition, neurinomas are benign tumors, and large doses of radiation are not required to suppress them.
If there is a threat of complications, doctors can irradiate the tumor not in a single procedure but in two to five procedures. Doctors use visual control, performing CT or MRI scans before each radiation session. The irradiation process is controlled in real time, and unwanted patient movements are excluded thanks to the use of vacuum mattresses and thermoplastic masks.
SBRT has been used as a treatment for benign spinal cord tumors since the 1990s. Initially, doctors used high doses of radiation, the same as for malignant tumors or cancer metastases to the spine, namely up to 30 Gy or more. Further studies have shown that such intense irradiation is not necessary.
In 2020, the American Association of Neurological Surgeons published the results of radiation therapy in 47 patients with benign spinal cord tumors, including 18 people with neurinomas. These results were published in the "Journal of Neurosurgery: Spine". The authors suggested that even a dose of 12-13 Gy would be sufficient to achieve the same results as when using a high dose, and their assumptions were confirmed. On average, tumor control over 5 years was achieved in 76% of cases, which is no worse than when using high doses of radiation. Furthermore, this results in less toxicity.
Benefits of Gamma Knife treatment for spinal neurinomas
The benefits of Gamma Knife treatment include the following:
- safety;
- lack of any discomfort (patients do not feel the radiation);
- minimal time spent: from 1 to 5 radiation sessions are performed, and doctors may also deliver the required dose of radiation in one fraction whenever possible;
- no need for rehabilitation;
- there are no risks associated with surgical treatment;
- the stability of the spine is maintained;
- even debilitated patients with concomitant somatic diseases can undergo treatment.
The Gamma Knife treatment, however, is less effective than surgery, so the technique is not considered a first-choice treatment option. In about three out of four cases, doctors manage to stop the growth of the tumor or shrink it. In one case out of four, the neurinoma continues to grow soon after radiation therapy or after several years, so there is a need for additional treatment. Moreover, tumor shrinkage does not occur immediately, and the maximum effect is achieved only after a few years. Therefore, neurological symptoms that have already manifested do not completely disappear.
Where to undergo your Gamma Knife treatment for spinal neurinomas?
You can receive your treatment abroad. Many hospitals in developed countries have Gamma Knife systems or other equipment for stereotactic body radiotherapy. Some of the benefits of receiving treatment abroad are as follows:
- the latest types of radiation therapy are available;
- advanced models of the Gamma Knife radiosurgery system are used;
- extensive and successful experience in radiotherapy for spinal cord tumors;
- spinal neurinomas can be destroyed in one session, if possible;
- if radiation doses need to be divided into several fractions, visual control is carried out before each irradiation session to increase the safety of treatment;
- the use of low doses of radiation that are sufficient to control the disease and, at the same time, are safe for patients.
You are welcome to use the Booking Health service to find out the cost of treatment and choose a medical care program at the best price. On our website, you can compare prices for medical services at different hospitals. If you make an appointment for your spinal neurinoma treatment through Booking Health, you will save. Our website presents direct hospital prices, and the cost of medical services will be lower than when you contact a medical center directly. This is due to the absence of taxes for foreign patients. The Booking Health employees will assist you with organizing your trip abroad. We will help you choose a hospital, book a hotel and airline tickets, and translate your medical documents into German or English. We will also provide an interpreter in another country, meet you at the airport, and take you to the hospital by car.
Authors:
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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