Radiosurgical Treatment Alternatives

The Department of Neurosurgery provides the full range of radiosurgery (surgery that uses radiation) options. Cedars-Sinai Medical Center is on the leading edge of this field and has the first FDA-approved, three-dimensional software for use during radiation therapy.

A leader in radiosurgery, Cedars-Sinai Medical Center is the first medical facility on the West Coast to offer the Radionics ConforMAX Mini-Multileaf Collimator (MMLC) and Head and Neck Localizer (HNL). The FDA-cleared ConforMAX MMLC is a device used to treat tumors. The radiation is beamed directly to the tumor, which lowers the risk to surrounding healthy tissue.

The MMLC system uses a headframe to prevent movement by the patient. Information from imaging tests are combined with the treatment planning software to view the brain tumor three-dimensionally and determine the exact angles and radiation doses needed to destroy the tumor.

Radiosurgery can be used to treat lesions and most malignant tumors that are either inaccessible or were treated unsuccessfully by conventional surgery, chemotherapy and/or radiation therapy. Radiosurgery does not cut through the skull or brain tissue at all. Radiosurgery uses a radiation unit containing sources of radioactive cobalt-60, a treatment-planning computer, a movable patient couch and headgear to treat cancer. The key to their success is the ability to locate the coordinates of a tumor in three-dimensional space with sophisticated imaging and then by means of a head-stabilizing helmet focus multiple beams of high-intensity radiation directly on a tumor. Because each individual beam is relatively low energy and extremely narrow, passing through only a tiny corridor of brain en route to its target, it leaves most normal tissue unharmed. Unlike conventional surgery, radiosurgery does not remove a mass; rather, it kills individual malignant cells over weeks and months by damaging DNA, which interferes with cells' ability to reproduce. If the tumor is benign, a single dose of radiation will be given. If the tumor is malignant, lower doses of radiation will be given over a series of sessions.

Radiosurgery has many advantages over surgery. Since there is no incision with radiosurgery, there is no risk of bleeding, infection or other possible complications of surgery. Furthermore, if a patient has several metastatic tumors, they can be dealt with in one session. Unlike conventional radiation therapy, the treatment is over in five or six hours, and patients do not experience nausea or hair loss (except perhaps in small spots if the tumor lies near the skull). More importantly, if new tumors should arise later, radiosurgery can be called upon again-several times if necessary, whereas repeated open-skull surgeries would be risky.

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