Selection of patient and pre-operation: The decision for Radiosurgery is taken after all information regarding the patient is evaluated and a consensus is founded by a board consistsing of a brain surgeon, radiation oncologist and other specialists. The consensus and possible alternative methods are conveyed to the patient and patient relatives. They are given information concerning the radiosurgery phases and the follow-up protocol. Since this method does not require any incision, hair cut or general anesthesia and it is a minimally invasive method, they are informed that the procedure will be completed during the day and the patient will be at home in the evening.
In in Gamma Knife Radiosurgery, placing the frame is the stage required to set target to be hit with high accuracy.The frame is stabilized rigidly on to the skull by screws on four different points which enables real streotactic radiosurgery treatment unlike many other radiotherapy methods.While the sensitivity is taken under guarantee by Elekta Corporation up to 0,5 mm, in daily application, the target is reached with higher sensivity, on average of 0,15 mm.
The frame is placed on the stabilisation points under mild sedation and local anesthesia is given to the stabilisation points on patient's head. The only disadvantage of this procedure, although it is easily tolerated by patients, is the limitation that it could not be applied under 8 year old children because of the insufficient thickness and hardness of their skull.
After radiologic imaging, patient is taken to the room and have a chance to rest, eat, drink etc during the 1-2 hour of dose planning period. Radiologic images, involved in stereotactic volume , are utilized in treatment planning program. The target and its borders are identified, dose to be sent is determined and dose planning is done on the target. These all stages are checked individually by Gamma Knife team.
After planning phase is accomplished, the patient is taken into treatment unit. The time period of treatment changes from a couple of minutes to a couple of hours according to number and size of lesions. Treatment unit is an extremely bright and wide area. Irradiation unit is also extremely wide and, so, there is no problem for claustrophobic patients. The patient is followed by a monitor and communicated vocally through the treatment period. In case of any problem, it is possible to give a break to the treatment and, then, continue from the same point.
Following the treatment, the frame is removed from the patient’s skull. A report including the details of therapy and planning phases is given to patient or patient relatives. The patient is taken to the room to rest for a couple of hours and discharged later. There are no post-therapy complications or side-effects observed.
The patient is controlled at certain time intervals depending on the treated lesions and periodically control-aimed radiologic images are taken.