77371 Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; multi-source Cobalt 60 based

Name of the Procedure:

Radiation Treatment Delivery, Stereotactic Radiosurgery (SRS), Complete Course of Treatment of Cranial Lesion(s) Consisting of 1 Session; Multi-Source Cobalt 60 Based

Summary

Stereotactic radiosurgery (SRS) is a non-invasive radiation therapy used to treat abnormalities, tumors, or lesions in the brain. This specific procedure uses cobalt-60 as a radiation source to deliver a single high-dose treatment precisely targeted at the cranial lesion.

Purpose

• Condition Addressed: Brain tumors, arteriovenous malformations (AVMs), and other abnormal brain lesions.
• Goals: To destroy or shrink the targeted lesion while sparing surrounding healthy tissue, leading to relief of symptoms and improved prognosis.

Indications

• Symptoms: Persistent headaches, seizures, neurological deficits, or vision problems.
• Conditions: Malignant and benign brain tumors, metastatic brain lesions, AVMs, trigeminal neuralgia.
• Criteria: Patients who have lesions that are inaccessible or unsuitable for conventional surgery.

Preparation

• Pre-Procedure Instructions: Patients may need to fast for a specific period before the procedure. They should follow all instructions given by their healthcare provider regarding medication adjustments.
• Diagnostic Tests: MRI or CT scans to accurately locate the lesion, blood tests, and a thorough medical history review.

Procedure Description

1. Anesthesia: Usually, local anesthesia is administered.
2. Immobilization: The patient's head is immobilized using a custom-fitted frame or mask to ensure precision.
3. Imaging: High-resolution imaging (MRI or CT) is performed to map the exact location of the lesion.
4. Treatment Planning: A treatment plan is created using specialized software that calculates the precise radiation dose.
5. Radiation Delivery: The patient is positioned on the treatment table, and the multi-source cobalt-60 machine delivers focused radiation beams converging on the lesion.
6. Completion: The frame or mask is removed after the procedure.

Duration

The entire procedure typically takes between 1 to 4 hours, depending on the complexity of the case.

Setting

Stereotactic radiosurgery is usually performed in a hospital's radiology or oncology department, often in a specialized radiation therapy unit.

Personnel

A multidisciplinary team including a radiation oncologist, neurosurgeon, medical physicist, and radiologic technologist performs the procedure.

Risks and Complications

• Common Risks: Fatigue, headaches, localized hair loss, and skin irritation at the treatment site.
• Rare Risks: Swelling of the brain (edema), neurological deficits, radiation necrosis, or seizures.
• Management: Ongoing monitoring, medications to reduce inflammation or manage symptoms.

Benefits

• Expected Benefits: High precision targeting results in effective lesion control with minimal damage to surrounding tissue. Symptom relief can often be realized within days to weeks.
• Long-Term Outcomes: Potentially curative for certain lesions, significantly prolonged quality of life, and reduced need for invasive surgery.

Recovery

• Post-Procedure Care: Short observation period after the procedure; usually, patients can go home the same day.
• Recovery Time: Most patients can resume normal activities within a few days.
• Follow-Up: Regular follow-up appointments to monitor progress with periodic MRI or CT scans.

Alternatives

• Other Treatments: Conventional surgery, whole-brain radiotherapy, fractionated radiotherapy, chemotherapy.
• Pros and Cons: SRS offers a non-invasive and highly precise option with fewer side effects, but may not be suitable for all types or sizes of lesions. Conventional surgery may be preferred for accessible tumors that can be completely removed.

Patient Experience

• During the Procedure: The patient should remain still but will not feel pain during radiation delivery. Any discomfort from the immobilization device is temporary.
• Post-Procedure: Mild fatigue or headache is common. Pain management medications and comfort measures will be available if needed.