Frequently Asked Questions
Radiosurgery is a surgical procedure aimed at the complete and precise destruction of a defined target volume containing abnormal or normal cells by a single high-dose radiation treatment without damaging surrounding tissue.
During radiotherapy, the patient is treated several times with low-dose radiation beams. The treatment can last up to a month. It is usually used to treat lesions where the aim is to treat as large a volume as possible and where the irradiation does not require high precision. Radiosurgery uses a single high-dose radiation to treat the lesion with millimeter precision.
1. Proton irradiation - cyclotron systems
2. Gamma radiosurgery - GammaKnife,
GammaART-6000, Masep, Our, etc.
3. LINAC (linear accelerator) based systems -
Novalis, Cyberknife, Xknife, Trilogy, etc.
At the Debrecen Gamma Radiosurgery Center, patients are treated with gamma radiosurgery.
Treatments are carried out using the American- made GammaART-6000 rotating gamma irradiation system.
Inside the device, a charge of 30 Co-60 isotopes is placed along a hemisphere. Each of these charges rotates around a circular arc about an axis parallel to the longitudinal axis of the control table. The gamma-ray beams emerging from the charges are directed to a common point, the so-called focal point. At the focal point, the effect of the beams, which come from many directions but are each of low intensity, is multiplied, enabling the beam to produce the desired biological effect at that point. The size of the focal point depends on the size of the collimators, which are located inside the device and in front of the beam sources and are variable in size. The radiation exposure of tissue outside the focal point is significantly lower than that of the treated area.
A form of radioactive radiation. During the decay of the Co-60 isotope, two high-energy electromagnetic waves are produced, 1.17MeV and 1.33MeV. These ionizing rays, which are invisible to the eye, are called gamma rays.
The device, its operation, the radioactivity of the radiation sources, the mechanical accuracy, and the computer and software used for its design are continuously checked and tested by a team of physicists under a rigorous quality control program.
The equipment in the radiosurgery center is mainly used to treat intracranial conditions such as brain tumors, vascular malformations, and certain functional pathologies such as facial nerve palsy.
The treatment triggers various biological processes in the treated area, which, depending on the dose and the lesion, may include cell death, scarring, vascular occlusion, acute inflammation, and brain edema.
No, the effect of the intervention is not immediate in the vast majority of cases and is highly dependent on the radiation dose delivered and the radiosensitivity of the formula. For the different processes, the reduction in size, vascular occlusion, and functional change takes a longer or shorter time. The development of the effect can take from months (1-2 months) to years.
A detailed description of the treatment can be found on the The treatment process subpage.
The course of treatment is the same, but different conditions are treated with different doses depending on the desired effect and the function and sensitivity of the surrounding tissue.
Fainting, headache, pressure in the head, nausea, general malaise, and neurological symptoms due to brain edema may occur. Most patients have no symptoms.
Not usually, but in some cases, anti-epileptic drugs or steroids are recommended to reduce brain edema. Sometimes, mood stabilizers are given to reduce symptoms during treatment and to reduce feelings of confinement. The patient will continue to take their regular medication.
Gamma knife treatment is a non-invasive treatment alternative to traditional cranial exploration techniques. It provides a one-off treatment for many patients who have previously been in doubt about undergoing any neurosurgical intervention at all. The treatment is associated with fewer risks, complications, morbidity, and mortality compared to traditional surgical procedures. Patients also recover more quickly. If necessary, oncological treatment can be continued after a few days. The treatment is less stressful for the patient's body and involves much less pain than open surgery. It does not require anesthesia in adults and can be performed in patients with poor general health where anesthesia has previously made this impossible.
The principles of the method were developed by neurosurgeon Professor Lars Leksell (Department of Neurosurgery, Karolinska University, Stockholm). He developed the principles 50 years ago. The first treatments started in the second half of the 1960s, and the process spread worldwide in the second half of the 1980s with the development of CT and MR equipment. Currently, there are hundreds of radiosurgery centers around the world. Almost half a million patients have been treated in recent years. In Hungary, LINAC-based stereotaxic point irradiation has been performed in Budapest since the early 1990s. In June 2007, Hungary's first Gamma Radiosurgery Center was inaugurated at the University of Debrecen Medical and Health Sciences Center. Since then, patients have been treated continuously.
In a few cases, the appearance of a malignant tumor that had not previously existed was described, but this can occur with any radiotherapy. The likelihood is extremely low. In very rare cases, unexpected tissue necrosis, neural pattern damage, and very marked brain edema and its sequelae may occur.
As the irradiation is targeted only at the affected area, the treatment can be repeated or extended to other areas if necessary.
It depends partly on the pathology and its location, but theoretically, there is no place inside the skull that gamma rays cannot reach. Of course, each case needs to be considered on its own merits.
For certain pathological processes, radiosurgery can be used not only instead of open surgery, but also in combination with it in addition to it.
It does not rule it out, even if the patient has previously received full cranial irradiation.
Neurosurgeons, physicists, health professionals, neuroradiologists, and managers.