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Gamma Knife in Multiple Metastasis

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One of the most sensitive and important organs in the human body is the brain. Brain metastases are secondary tumours that develop when cancer from other regions of the body spreads to the brain. Many people may have several metastases that impact different parts of their brains, rather than simply one. Multiple brain metastases were difficult to treat in the past and frequently required whole-brain radiation therapy (WBRT), which could damage healthy brain tissue and result in adverse consequences including memory loss.

Gamma Knife in Multiple Metastasis
Gamma Knife in Multiple Metastasis

Even in cases where several tumours are present, Gamma Knife Radiosurgery provides a more accurate, focused, and successful therapeutic alternative.

Gamma Knife: Why Use It for Multiple Metastases?

Multiple Metastasis

  • Accuracy in Therapy

Regardless of its size or location, every metastatic tumour can be precisely targeted without compromising healthy brain structures.

  • Concurrent Management

Many hospital trips can be avoided by treating many brain metastases in a single session.

  • An improved standard of living

Patients maintain improved memory and everyday functioning by avoiding the cognitive deterioration frequently linked to whole-brain radiation.

  • Quick Recuperation

Within 24 to 48 hours, most patients are able to return to their regular activities.

Who’s Eligible?

Treatment with a Gamma Knife might be advised if:

Treatment with a Gamma Knife might be advised if
Treatment with a Gamma Knife
  • The brain has several small-to-medium-sized metastases.
  • Overall, the patient is doing well.
  • Systemic treatment is working or the primary cancer is under control.
  • On MRI scans, the metastases are clearly visible.

To determine eligibility, a radiation oncologist and neurosurgeon will collaborate and consider imaging, medical history, and overall prognosis.

How is the process carried out?

How is the process carried out
How is the process carried out

  • First Consultation and Imaging

To identify each tumour and accurately schedule treatment, the procedure begins with a comprehensive MRI scan.

  • Positioning of the Head Frame or Mask

Either a lightweight stereotactic frame or a specially made mask is utilised to keep the head still.

  • Planning for Treatment

A 3D map of the brain is produced by sophisticated computer tools, pinpointing the precise locations of each metastasis.

  • Gamma Knife Provision

The machine targets each tumour with concentrated gamma rays while the patient is peacefully resting on the treatment sofa.

Depending on the amount of lesions, the painless procedure usually takes 30 minutes to several hours.

  • Care Following Treatment

After a brief observation, patients are typically released the same day.

Advantages Compared to Traditional Therapy

Advantages Compared to Traditional Therapy
Advantages Compared to Traditional Therapy
  • Non-invasive: No anaesthesia or incisions are needed.
  • High Accuracy: Accurately targets tumours within millimetres.
  • Multiple tumours are treated in a single session during a single-day procedure.
  • Minimal Side Effects: Compared to WBRT, there is a lower chance of cognitive deterioration, exhaustion, and hair loss.

Potential Adverse Reactions

Gamma knives are generally safe, although some patients might have the following side effects:

  • Mild nausea or headache (temporary)
  • Localised cerebral swelling that would require temporary steroid treatment
  • Necrosis, or dead tissue at the treatment site, is an uncommon consequence of delayed radiation.
  • When compared to traditional whole-brain radiation, these hazards are significantly lower.

Aftercare (Gamma Knife treatment)

Following Gamma Knife treatment, routine MRI scans are necessary to track tumour response and identify any new lesions as soon as possible. If new metastases develop, more Gamma Knife sessions may be necessary in some situations.

In conclusion

The treatment of numerous brain metastases has been completely transformed by Gamma Knife Radiosurgery, which provides a minimally invasive, safe, and efficient substitute for conventional radiation therapy. Its unparalleled accuracy aids in the management of brain tumours while maintaining the patient’s cognitive abilities and standard of living.

A specialist neurosurgeon with experience in Gamma Knife treatment can help you decide if this innovative therapy is the best option if you or a loved one has been diagnosed with brain metastases.

Sources:

  1. https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.3322/canjclin.48.3.177
  2. https://pubmed.ncbi.nlm.nih.gov/11143258/
  3. https://pmc.ncbi.nlm.nih.gov/articles/PMC4101747/
  4. https://www.sciencedirect.com/science/article/abs/pii/S187887501930645X
  5. https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/canjclin.48.3.177
  6. https://link.springer.com/chapter/10.1007/978-3-7091-0583-2_9
  7. https://link.springer.com/article/10.1007/s00701-004-0306-4
  8. https://www.southsoundgammaknife.com/conditions-we-treat/gamma-knife-treatment-metastatic-tumors/
Picture of Khyati Pathak

Khyati Pathak

Last Edited on 03/09/2025

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You May Also Know Related to Gamma Knife
FAQ’s

Gamma Knife uses 192–201 precisely focused beams of gamma rays that converge at a single target point in the brain. This high dose of radiation damages the DNA of abnormal cells, stopping their growth or causing them to shrink, while minimizing exposure to nearby healthy tissue.

No, Gamma Knife is not a traditional surgery. It is a non-invasive outpatient procedure performed without any incision, stitches, or general anesthesia in most cases.

Gamma Knife is commonly used for:

Brain tumors (benign and malignant)
Metastatic brain lesions
Arteriovenous malformations (AVMs)
Trigeminal neuralgia
Acoustic neuromas (vestibular schwannomas)
Pituitary tumors
Certain functional disorders (like tremors)

The procedure is generally painless. Patients may feel mild pressure while the head frame (if used) is applied or may experience slight discomfort from anesthesia injections, but the treatment itself is not painful.

Depending on the condition and treatment plan, Gamma Knife may take 30 minutes to 3 hours. Most patients go home the same day.

Common side effects are usually mild and temporary, including:

Headache
Nausea
Fatigue
Mild scalp swelling or tenderness at the frame site
Rarely, some patients may experience delayed radiation effects such as brain swelling or radiation necrosis.

Most patients can return to their normal routine within 24–48 hours after the procedure.
You may feel mild fatigue for a few days.
Follow-up imaging is usually required after 1 year.

Gamma Knife has a high success rate and has been used worldwide for decades. Its effectiveness depends on the condition treated, size and location of the lesion, and overall patient health. In many cases, it offers results comparable to open surgery with fewer risks.

Yes, in some cases Gamma Knife treatment can be repeated if the disease recurs or if new lesions develop.

Yes. Gamma Knife is considered one of the safest and most precise forms of radiosurgery, with millions of patients treated globally and extensive clinical data supporting its use.

Eligibility depends on factors such as:

Size and location of the lesion
Overall health and age
Whether open surgery is too risky
A neurosurgeon and radiation oncologist will decide if Gamma Knife is the best option for you.

A detailed MRI or CT scan is performed to map the brain.
A lightweight head frame or mask is used for accuracy.
Your doctors plan the radiation dose and target areas using specialized software.

Local anesthesia is given if a head frame is used.
General anesthesia is usually not required, except for children or patients unable to remain still.

Costs vary depending on hospital, city, and condition treated. On average, Gamma Knife in India ranges from ₹1.5 lakh to ₹4.5 lakh. It is usually more affordable compared to treatment in Western countries. At AIIMS Delhi, it is much more affordable around ₹75,000 which makes it affordable for the patients in need.

AIIMS Delhi is one of the leading centres for Gamma Knife in India.

AIIMS uses the latest Gamma Knife Perfexion system.

It has successfully treated thousands of patients for brain tumors, blood vessel problems, and even eye cancers.

The treatment is done by expert neurosurgeons such as Dr. Deepak Agrawal and team.

Clinic timings for Gamma Knife OPD at AIIMS Delhi: Monday & Friday, 8:00 AM – 9:00 AM.

Cost is around ₹75,000 and is subsidized compared to private hospitals.

The whole procedure is usually done in one day:

  • Consultation & Planning – Doctors review your scans and decide the treatment.
  • Head Frame/Mask – A lightweight frame or mask is placed to keep your head still.
  • Imaging – MRI/CT scans are done to locate the exact target.
  • Treatment Planning – Specialists plan the dose and direction of radiation.
  • Gamma Knife Treatment – You lie on the machine; painless radiation beams treat the target (30 mins–3 hrs).
  • Recovery & Discharge – The frame is removed, and most patients go home the same day.
  • Follow-up – MRI after a few months to check results.

Before you get a treatment date, you need to complete a few steps:

  • OPD Registration – Visit the Neurosurgery OPD (Gamma Knife clinic at AIIMS, Mon & Fri 8–9 AM) and register.
  • Consultation with Doctor – Meet the neurosurgeon who will check your reports, MRI/CT scans, and medical history.
  • Investigations – Sometimes fresh MRI/CT or blood tests are needed for treatment planning.
  • Medical Fitness – Basic checks like blood pressure, sugar, heart condition, etc.

Financial/Insurance Approval –

  1. If using Ayushman Bharat or government schemes, you need approval papers.
  2. If self-paying, you will be given the estimated cost (~₹75,000 at AIIMS).
  • Consent & Admission Slip – Once doctors confirm you are fit and formalities are done, you sign the consent form.
  • Treatment Date Allotment – A date is given for your Gamma Knife procedure.

Once you receive your Gamma Knife date, you’ll need to do a few simple things before the procedure:

  • Admission Process – Report to AIIMS on the morning of your procedure and complete admission at the Neurosurgery ward/Daycare.
  • Paperwork – Carry your OPD slip, MRI/CT films, blood test reports, admission slip, and ID proof. If you are covered under Ayushman Bharat/insurance, keep those approval papers ready.
  • Consent Forms – You (or a family member) will sign consent for the procedure and anesthesia.
  • Medical Check-up – Doctors will check your BP, sugar, heart rate, and do a quick physical exam.
  • Fasting – Usually, you will be asked to not eat or drink for 6 hours before the procedure.
  • Pre-Procedure Prep – An IV line may be put, and medicines (sedation/antibiotics if needed) are given.
  • Treatment – You are then taken to the Gamma Knife room for frame/mask placement, imaging, and treatment.

After the procedure, you’ll be observed for a few hours and most patients are discharged the same day or next morning.

Urea & creatinine

No, You can have light breakfast.

Yes, you can take the medicine and then come for the treatment.

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