title: Successful conversion from a linear accelerator-based program to a Gamma Knife radiosurgery program: the Cleveland Clinic experience.
abstract: From August 1989 to January 1997, 307 treatments in 293 patients were performed with a linear accelerator-based (LINAC) stereotactic radiosurgery system. Because of the program s success, the need for a dedicated radiosurgery unit in Ohio and the desire to treat functional disorders, the Cleveland Clinic Health System (CCHS) obtained the first Gamma Knife in the state of Ohio. Based on the previous volume of patients for radiosurgery, it was estimated that 75-100 patients would be treated during the first year of operation. However, during the first calendar year, 214 treatments were performed on 205 patients, which far exceeded expectations. The success of the CCHS Gamma Knife Center can be attributed to an increase in a number of factors. These included marketing efforts, patient awareness, increased use for functional disorders, physician understanding of radiosurgery, use by qualified nonaffiliated radiation oncologists and neurosurgeons, and outpatient delivery (95% with the Gamma Knife vs <5% with the LINAC). With proper planning, education, and awareness, the opening of a Gamma Knife Center can greatly increase the volume of radiosurgery performed when compared with a LINAC-based program.
authors.affiliation: Department of Radiation Oncology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. suh@radonc.ccf.org
authors.forename: J H
authors.initials: JH
authors.lastname: Suh
authors.forename: G H
authors.initials: GH
authors.lastname: Barnett
authors.forename: D W
authors.initials: DW
authors.lastname: Miller
authors.forename: R L
authors.initials: RL
authors.lastname: Crownover
authors.forename: T R
authors.initials: TR
authors.lastname: Willoughby
authors.forename: M S
authors.initials: MS
authors.lastname: Weinhous
authors.forename: P A
authors.initials: PA
authors.lastname: Barrett
authors.forename: J G
authors.initials: JG
authors.lastname: Walsh
authors.forename: R M
authors.initials: RM
authors.lastname: Macklis
mesh_terms: D001932:Brain Neoplasms / Q000145:classification / Q000556:secondary / Q000601:surgery*; D006801:Humans; D008577:Meningeal Neoplasms / Q000601:surgery; D008579:Meningioma / Q000601:surgery; D009820:Ohio; D016522:Oncology Service, Hospital / Q000458:organization & administration; D010315:Particle Accelerators; D018787:Radiation Oncology / Q000458:organization & administration; D016634:Radiosurgery / Q000295:instrumentation* / Q000379:methods*; D012189:Retrospective Studies; D013503:Surgery Department, Hospital / Q000458:organization & administration