Unlike conventional neurosurgery, sterotactic radiosurgery involves no incision and has virtually no acute side effects. The treatment procedure is planned in 'virtual reality' first, then performed, assuring extreme accuracy.

Brain surgery. The mere mention of it sends chills down the spines of most people. Even as recently as last year, the surgery to remove a lesion on Gordon York's auditory nerve would have meant scalpels, invasive procedures, and an extended recovery time.

"The last thing my father-in-law needed," said University of Iowa Cancer Care neurosurgeon Patrick Hitchon, MD, "was traditional brain surgery. He is 80 years old, has had by-pass surgery, two angioplasties, and has leukemia.

"When he asked my advice, I told him he should be treated by physicians who have the most experience, and here, we have the advantage of experience," Hitchon said.

Enter stereotatic radiosurgery technology-the newest tool in the UI Cancer Center's arsenal to treat brain tumors. Doctors can now use this new therapy to deliver a one-time, high dose of radiation to the target area, eliminating the need for traditional surgery.

"Medtronic's new Precision 2000TM stereotactic radiosurgery system has the highest degree of precision of any non-surgical system available," said radiation oncologist John Buatti, MD. "In conventional radiotherapy, we relied on our own medical anatomy knowledge with manual mapping of tumors with an accuracy margin of about 1-2 centimeters. Now, with the technology we've developed, the coordinates can be correlated to within two-tenths of a millimeter, a significant increase in accuracy."

The new technology, introduced at UI Hospitals and Clinics in June, cuts by two-thirds or more the costs of traditional brain surgery when stereotatic radiosurgery is appropriate. It is effective on small tumors, but not appropriate for all tumors, especially large ones. Radiosurgery is particularly useful for children and patients with high-risk medical histories that make traditional surgical treatment impossible. The new technology is used in combination with standard treatments for brain tumors and abnormalities, including fractionated radiotherapy, neurosurgery, and chemotherapy.

An additional advantage of the new therapy is that it is non-invasive. Stereotactic radiosurgery combines components of both radiation therapy and neurosurgery delivered through a computer-guided system, aiming highly focused beams directly into deep brain tumors and other brain abnormalities, using a linear accelerator as the radiation source.

Hitchon, who co-directs the program with Buatti, said, "The beauty of this new treatment is that it is delivered as outpatient surgery. Unlike conventional neurosurgery, stereotactic radiosurgery involves no incision and has virtually no acute side effects. The treatment procedure is planned in 'virtual reality' first, then performed, assuring extreme accuracy."

York, a retired Bettendorf, Iowa, dentist, had surgery on a lesion on an auditory nerve and was out of the hospital the same day. Like York, most people return to their normal lifestyles shortly after stereotatic radiosurgery.

In addition to Buatti and Hitchon, the radiosurgery team includes radiation physicist, Sanford Meeks, PhD, and as well as neurosurgeons, radiation oncologists, radiation physicists, and computer programmers.

Buatti pioneered the development of the optic-guided stereotactic radiation delivery system and collaborated with Meeks to treat more than 1,500 patients with stereotactic radiosurgical techniques at the University of Florida, where they were both faculty members before joining University of Iowa Health Care last year. Buatti's work on the treatment of central nervous system lesions and radiosurgery has been presented in more than 100 publications, including a textbook on radiosurgical practice.

Hitchon has more than seven years experience in radiosurgical practice and has extensive experience using radiation seeds to treat patients with brain tumors.

For more information about stereotactic radiosurgery, patients and families should call the UI Health Access toll-free number, 800-777-8442, and ask for Dr. Patrick Hitchon or Dr. John Buatti. For consultation or referral, physicians should call UI Consult, 800-322-8442.

Physicist Sanford Meeks, PhD., adjusts the sterotactic radiosurgery head frame for patient Gordon York.