Our Program

The USC Stereotactic Radiosurgery Center at Keck Medical Center of USC in Los Angeles provides an innovative, outpatient-based surgical method for treating tumors of the brain and spine. The center consists of three of the most effective radiation oncology treatments available: Gamma Knife® Perfexion, CyberKnife® and TrueBeam™ Stx. All of these procedures are conducted without an incision or general anesthesia, and without the need for a hospital stay.

Stereotactic is a three-dimensional positioning and measurement system. Radiosurgery is a specialized form of treatment that allows for precise delivery of radiation to a target. The target is treated with similar precision as a surgeon would in a surgery, and radiosurgery can treat tumors without significant damage to surrounding tissues.

Our Approach

We have been among the pioneers of radiosurgical treatments for the past several decades. Our program remains in the forefront of innovative applications of radiosurgical treatments for brain, spine and systemic diseases.

Using a team approach toward diagnostics and treatment of patients with brain and spine tumors, our multi-disciplinary team offers patients the most advanced and sophisticated radiosurgical treatments. Every week, neurosurgeons, radiation oncologists and experienced physicists meet to determine the best treatment options for our patients. The specialists in the program, who include physicians at Keck Hospital of USC and the USC Norris Comprehensive Cancer Center, have performed thousands of procedures with the Gamma Knife® (including the latest Perfexion model)¬, CyberKnife® and TrueBeam™ Stx. When used appropriately, the Gamma Knife® and other radiosurgical technologies are very safe complements to conventional surgery and chemotherapy.

As the only institution in Southern California to offer these three technologies in one location, our physicians are able to provide patients with the best possible course of treatment. Each one is designed to support more favorable results while minimizing both side effects and length of treatment.

Many of the innovations in stereotactic surgery were invented or refined at Keck Medicine of USC. The technology that preceded the original CyberKnife® robotic surgical system was invented at USC. Additionally, our physicians helped create resting frames for the head and other equipment that made navigation through the skull, brain and spine more precise during Gamma Knife® procedures.

Outcomes

The USC Stereotactic Radiosurgery Center at Keck Medical Center of USC is considered one of the nation’s leading centers for Gamma Knife® and other incision-free techniques in the treatment of brain and spine tumors. The team has published results showing more than 95 percent tumor control over five years.

Data were reviewed in 116 patients who underwent 136 Gamma Knife® treatments for benign intracranial meningiomas from 1996 to 2004.

Number of patients: 116
Number of Gamma Knife® procedures: 136
Number of tumors controlled: 128 (94 percent)
Five-year tumor control rate: 98 percent
Ten-year tumor control rate: 84 percent

Source: Zada, G., et al. (2010). Long-term outcomes and patterns of tumor progression after gamma knife radiosurgery for benign meningiomas. Neurosurgery, 67(2), 322-329. http://www.ncbi.nlm.nih.gov/pubmed/20644417

Conditions

The main techniques in the USC Stereotactic Radiosurgery Center — Gamma Knife®, CyberKnife® and TrueBeam™ Stx – are used for radiosurgery on well-defined solid tumors in the brain and spinal cord. Some procedures are conducted directly on tumors that have been diagnosed, while other procedures are conducted to treat remnants of tumors or residual areas of tumors after traditional surgery.

Radiation therapy uses high energy radiation to kill cancer cells and shrink tumors by damaging the cell’s DNA, making it impossible for these cells to continue to grow and divide. The radiation directly damages the cell’s DNA, or alternatively, creates free radicals within the cell that cause damage to the DNA. Since radiation can also harm the DNA of healthy cells, the radiation oncologist must ensure that each treatment plan be devised and implemented to minimize the exposure of normal tissue during radiation therapy.

Types of disorders treated:
Meningeal tumors – Can stop growth of brain and spinal meningiomas for decades
Trigeminal Neuralgia – Can reduce the pain and the need for medication in 70 percent of cases
Arteriovenous Malformations – Can obliterate AVMs in 80 percent of cases
Metastatic tumors – Can suppress regrowth of tumors in the spine and brain that have spread from the original tumor site

Treatments and Services

The USC Stereotactic Radiosurgery Center at Keck Medical Center of USC in Los Angeles offers radiation therapy either alone or in conjunction with surgery and/or chemotherapy. Our stereotactic (a three-dimensional positioning and measurement system) radiosurgery program offers these services:

Gamma Knife® radiosurgery is a non-invasive alternative to traditional brain surgery, directing a precise beam of radiation to the targeted area of the brain. For many conditions, treatment using the Gamma Knife® Perfexion – the newest model – is the most accurate form of stereotactic radiosurgery available. With it, 192 beams of cobalt-60 radiation are delivered through the skull to a small and critically located area inside the skull, to stop or alter tissue growth.

The Gamma Knife® contains no blade and makes no incision. It combines data from three-dimensional computer imaging studies with a stereotactic head frame to precisely focus radiation.

Learn more about the Gamma Knife®

CyberKnife® radiosurgery is a non-invasive alternative to surgery for the treatment of tumors in multiple locations in the body. CyberKnife® treatments also involve no cutting, instead delivering beams of high dose radiation to tumors anywhere in the body with extreme accuracy. The CyberKnife® system is the world’s first and only robotic radiosurgery system designed to treat tumors.

Using image-guidance and computer-controlled robotics, the CyberKnife® tracks the tumor’s position, detects any tumor or patient movement and automatically corrects treatment delivery.

The TrueBeam™ Stx radiotherapy system is a non-invasive system that delivers powerful radiation to even more precise areas than possible with other technologies, in the head and neck, lung, liver and other areas. The TrueBeam™ Stx system can target tumors and other disorders in areas close to critical structures in the body and direct a precise beam of radiation without harming those structures. In addition, a treatment of radiation therapy using the TrueBeam™ Stx system can take just a few minutes, minimizing patient discomfort.

Patient Information

What to Expect

All stereotactic radiosurgery procedures at Keck Medical Center of USC in Los Angeles are done on an outpatient basis. Hospital stays are brief, if they are necessary at all. For most patients, the procedure requires a half-day commitment in one or multiple sessions.

For the Gamma Knife®, CyberKnife® or TrueBeam™ Stx treatments, patients will consult with their doctors and the stereotactic radiosurgery team to plan their procedure. Upon arrival for the procedure, they will receive a sedation anesthesia, but will remain conscious. When the patient is ready for the surgery, the patient is fitted with a stereotactic head frame, which serves as a measuring guide and helps keep the head in a fixed position to assure maximum treatment accuracy. The frame’s external axis is used to determine coordinates for targeting the tumor or lesion.

After the frame is attached, the patient receives an MRI, CT or angiographic scan. Data from the imaging study is transferred into the state-of-the-art treatment planning computer, which enables the treatment team (a neurosurgeon, radiation oncologist, radiation physicist and technicians) to tailor distribution of the radiation dose to conform specifically to the mass and size of the tumor or lesion. Completing the treatment plan takes one to two hours, depending on the complexity and location of the disease.

In the CyberKnife® outpatient procedure, anesthesia or invasive stabilizing frames are not required. Most patients experience minimal recovery time and can return to normal activities almost immediately.

Resources

Clinical Trials
Patients have the option of taking part in clinical trials being conducted at Keck Medical Center of USC and our affiliate locations. While clinical trial participation does not ensure that an effective treatment will be received, participation does help provide invaluable information for future treatments, and possibly a cure in the future.

Learn about neurosurgery clinical trials using stereotactic radiotherapy techniques at Keck Medicine of USC in Los Angeles here:

Stereotactic Radiosurgery or Whole-Brain Radiation Therapy in Treating Patients with Brain Metastases That Have Been Removed By Surgery.

Stereotactic Radiation Therapy With or Without Whole-Brain Radiation Therapy in Treating Patients with Brain Metastases.

Our Physicians

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Practicing Locations

Keck Hospital of USC
LAC+USC Medical Center
USC Healthcare Center 2
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Practicing Locations

USC Norris Comprehensive Cancer Center and Hospital
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Practicing Locations

Keck Medicine of USC - Beverly Hills
USC Healthcare Center 4

Specializing In

Acoustic Neuroma, Meningioma and Facial Nerve Tumors, Skull Base Surgery, Microvascular Decompression, Chronic Ear Infections, Otosclerosis, Meniere’s Disease and Pediatric and Adult Cochlear Implants

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Practicing Locations

USC Healthcare Center 2

Specializing In

Cerebrovascular Disease of the Brain and Spinal Cord, Surgical Approaches to the Cranial Base, Stereotactic Radiosurgery, Microvascular Decompression for Bell’s Palsy, Lateral Skull Base Surgery for Facial Nerve Tumors

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Practicing Locations

USC Healthcare Center 2
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Practicing Locations

Keck Hospital of USC
Keck Medicine of USC - Pasadena
USC Healthcare Center 4
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Practicing Locations

Keck Hospital of USC
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Practicing Locations

Keck Hospital of USC
USC Healthcare Center 2
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Practicing Locations

Keck Hospital of USC
USC Healthcare Center 2
USC Norris Comprehensive Cancer Center and Hospital

Additional Faculty

Cheng Yu, PhD