Beyond the ten thousand: experiences of the Sheffield Gamma Knife unit

Andras Kemeny1, Matthias Radatz2, Jeremy Rowe3

1S Yorks, United Kingdom 2National Centre For Stereotactic Radiosurgery, Sheffield 3Sheffield, United Kingdom

Keywords: gamma knife, vestibular schwannoma, arteriovenous malformation, brain tumor, radiosurgery

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     The Sheffield Gamma Knife program was installed in 1985.
Our purpose was to reeview the 25 year experience with Gamma Knife technology.
     Since its installation in 1985 the Gamma Knife unit in Sheffield has treated 11,310 patients.
      Retrospective analysis of the prospectively maintained database, supplemented by disease-specific retrospective case-note review was carried out.
     The steadily increasing annual treatment numbers provided immense opportunities to acquire large experience in the management of the common indications (over 5000 AVMs, over 2500 vestibular schwannomas, over 1000 meningiomas etc). This resulted in dramatic changes in the management paradigms for vestibular schwannomas in the UK and there are encouraging signs that the same is happening for meningiomas. This large practice also offered deeper understanding of the response to radiosurgery of rare pathologies e.g. pineal tumours, trigeminal neuromas, phacomatoses and a large series of over 100 glomus jugulare tumours. The particular commissioning (reimbursement) arrangements in the United Kingdom have resulted in peculiarities of case-mix, particularly in withholding treatment for many patients with metastases.
     The data was reviewed retrospectively.
     Despite the unchanged principle of gamma knife structure, the developing technology and particularly the evolving radiological support has offered an increasingly precise and tailored treatment. 
     This paper will analyse the effects of these technology changes upon the treatment delivery and outcome.


Project Roles:

A. Kemeny (), M. Radatz (), J. Rowe ()