With Elekta’s Extend program for Gamma Knife Perfexion, Barnes-Jewish doctors will be able to treat over two to five radiosurgery sessions patients with larger tumors or lesions close to critical structures located in the brain, skull base and in other regions in the head and neck.

Extend is a program that allows clinicians to non-invasively fix or immobilize the patient’s head, making repeatable or ‘hypofractionated’ Gamma Knife surgery practical for these cases. While single fraction Gamma Knife surgery excels in treating small malignant and benign lesions and those in less critically located regions in the head, Extend captures treatment indications in which a hypofractionated approach has the potential for a better clinical result.

In evaluating their decision to acquire Extend, the radiation oncology and neurosurgery departments also provided information on the solution to ENT (ear-nose-throat) physicians in the otolaryngology department to determine their interest. These clinicians could refer certain cases for hypofractionated radiosurgery with Extend, including patients with nasopharygeal carcinoma, paranasal sinus tumors and extensive skull base tumors, he says.

The key components of Extend are patient-friendly fixation devices, such as a vacuum assisted bite block and head support with vacuum pillow. Accurate repeat fixation is ensured with a one-time use of a CT box to obtain precise stereotactic reference points, followed by repeat checks using reposition check instruments for each Gamma Knife session.

Joseph Simpson, co-director of Gamma Knife of St Louis at Barnes-Jewish Hospital, said: “Extend represents additional growth in our capability and flexibility to meet patient needs with specialized radiation therapy.

“We typically use linear accelerator-based radiotherapy to treat these tumors. However, the disadvantage of that technique for glomus jugulare lesions is that they require more fractions, which means more time and greater potential for side effects.”