Gyroscopic Stereotactic Radiosurgery: A Retrospective Analysis.

Area of Science:

• Neurosurgery
• Radiation Oncology
• Medical Physics

Background:

• Stereotactic radiosurgery (SRS) is a standard treatment for brain tumors.
• A novel gyroscopic, frameless, self-contained, and self-shielded radiosurgery system has been developed.
• This system features a 2.7-MV linear accelerator with onboard image guidance.

Purpose of the Study:

• To present the initial clinical experience with this new gyroscopic radiosurgery system.
• To evaluate the safety, efficacy, and dosimetric performance of the novel platform.
• To assess treatment outcomes including local control and toxicity.

Main Methods:

• Retrospective analysis of 30 patients treated between September 2020 and July 2023.
• Treatment of 107 lesions including brain metastases, skull base tumors, and arteriovenous malformations.
• Data collection on delivered doses, treatment times, dosimetric parameters, and toxicity.

Main Results:

• 95% local control was achieved at a median follow-up of 14.7 months.
• Median treatment time was 24 minutes per lesion with a median of 74 beams.
• Acute toxicity was observed in 16.2% of patients; late toxicity included radiation necrosis and Bell's palsy, with no grade 4+ events.

Conclusions:

• The gyroscopic radiosurgery system demonstrates functionality, performance efficiency, and dosimetric benefits.
• Treatment outcomes align with historical data from other SRS modalities.
• This represents one of the largest published clinical experiences with gyroscopic radiosurgery to date.