Gamma Knife Radiotherapy for Children, Teenagers and Young Adults

The leaflet describes Gamma Knife Radiotherapy planning and treatment. It also explains the side-effects, which you / your child may experience during and after treatment.

Each person’s treatment will vary so the information given is a general guide. If you have any questions after reading this leaflet, please speak to the team. The team will make every effort to meet your / your child’s individual needs or will direct you to the person who can help.

Children, teenagers and young adults receiving Gamma Knife Radiotherapy are treated at Leeds Cancer Centre at St. James’s University Hospital, LS9 7TF.

What is Gamma Knife Radiotherapy?

Gamma Knife is not a knife as we know it. It is a machine (see photo below), which delivers focused beams of gamma radiation. These beams are used to treat brain lesions.

The Gamma Knife team

Clinical Oncologist and Neurosurgeon

The clinical oncologist and neurosurgeon are consultants who are responsible for and supervise you / your child’s course of treatment.

Paediatric Therapeutic Radiographers

The paediatric therapeutic radiographers offer advice, information and support to you / your child and family during the radiotherapy process. They will be a point of contact throughout treatment preparation, planning, delivery and follow-up. We also have therapeutic radiographers called ‘buddies’. They give you additional support throughout your / your child’s course of treatment.

Paediatric Radiotherapy Nurse Specialist

The paediatric nurse specialist provides support, information and advice to patients and their families for the duration of planning, treatment and follow-up. We also have a nurse who will give additional support throughout your / your child’s course of treatment.

Play Specialist

The play specialist supports you / your child throughout radiotherapy preparation and delivery, and provides coping mechanisms to reduce fears and concerns.

Therapeutic Radiographers

Therapeutic radiographers are the professionals who operate
the Gamma Knife treatment machine. They are specially trained in the accurate planning and delivery of radiotherapy treatment.

Physicists and Dosimetrists

The physicists and dosimetrists work behind the scenes to accurately plan your / your child’s treatment.

Being referred for Gamma Knife Radiotherapy

Your primary treatment centre will refer you / your child to the team in Leeds, who will discuss you / your child and their treatment at a multi-disciplinary team meeting.
Before your / your child’s planning and treatment appointments, you will have an introductory meeting with your / your child’s consultant. This may be done in person or over the phone / via a video link. During this appointment, you will meet members of the team and will be able to familiarise yourself with the department. We will discuss the Gamma Knife planning and treatment processes, and you will have the opportunity to ask any questions you may have.

Additional information

You / your child will be supported and reviewed regularly by the paediatric radiotherapy team. We will liaise closely with your paediatric oncologist / Teenage and Young Adult key worker to arrange follow-up appointments as required.

The majority of children and young adults will receive Gamma Knife Radiotherapy treatment as an outpatient. Gamma Knife Radiotherapy is delivered on a daily basis (excluding weekends) for up to five treatments. Your / your child’s clinical oncologist will inform you how many treatments are required. Planning and treatment appointments may be on the same day or split over a couple of days. The team will inform you of the timescale. If you require transport to attend, please inform a member of the team. We may also be able to arrange an overnight stay for appointments on separate days. Please speak to a member of the team if you would like us to arrange this.

The Gamma Knife process

The Gamma Knife treatment process consists of four steps:

Immobilisation mask and CT scan

You / your child will require an immobilisation mask to ensure they are in the same position for each treatment. The mask is a mould of their head made by the therapeutic radiographers (see photo above). A CT scan will be taken, while you / your child are / is in the mask. This is not diagnostic and is used for planning purposes only.

MRI scan

A MRI scan will be taken to determine the exact shape, size and position of the treatment area. This will be used for planning your / your child’s treatment.

Treatment planning

The clinical oncologist, physicists and dosimetrists will create a unique treatment plan using the images gathered from the CT and MRI scans.

Treatment

For treatment, you / your child will be laid on a treatment couch with the mask fitted to keep them in the same position. A CT scan is performed before each treatment to make sure you / your child is in the accurate position. The treatment couch will move into position in the treatment unit for gamma radiation delivery. Your / your child’s position will be tracked and corrected throughout treatment to ensure accuracy. You / your child will be on their own for treatment but will be observed on cameras at all times. The team can also speak to you / your child via an intercom system. You / your child will not feel or see anything during treatment. You / your child may hear a buzzing noise whilst the treatment is being delivered.

Maintaining a stable position is vital for accurate Gamma Knife Radiotherapy. Each child or young person is assessed for their particular needs before any planning takes place. If you / your child requires a general anaesthetic, you will be provided with the General Anaesthetic for Radiotherapy booklet. We will discuss with you what this involves.

Acute side-effects of Gamma Knife Radiotherapy

Acute side-effects occur during the course of treatment, or in the first few weeks after treatment is completed. The team will discuss side-effects of treatment in detail when you have your introductory meeting.

Fatigue

You / your child may feel very tired whilst having Gamma Knife treatment and for some time afterwards. This is a common side-effect and can be helped by keeping yourself / your child hydrated, and making sure they get plenty of rest.

Swelling

Swelling around the treatment site may cause headaches, nausea, or vomiting. Your / your child’s consultant may be able to prescribe anti-sickness medication if this occurs.

Skin irritation / Hair loss

The area where the treatment has been directed may become red or darker in colour and feel sore. You / your child may also experience hair loss in this area.

Late side-effects of Gamma Knife Radiotherapy

Late side-effects may occur many years after treatment has finished. They are dependent on the area being treated and the dose of radiation given. Your child’s consultant will discuss these with you in more detail at your introductory meeting.

Contact details

Local support services