1. Leksell Gamma Knife® Icon™
Clinical Experience
[Document reference number: ]

2. Overview of treatment patterns to date
Survey of current clinical experience
Overview based on survey of 11 operational sites
Directional information only
To protect the integrity of the reporting centers, no center-specific data is published
Data was reported from July 2015 through July 2016
Regional distribution of reporting centers

3. Global case mix

4. Immobilization: distribution of methods utilized

5. Immobilization: distribution of methods utilized
July 21, 2018
Immobilization: distribution of methods utilized
Per highest volume indications
Choice of fixations used, example:
Adapted from: Transforming brain radiosurgery: Clinical application of a novel tool.
Webinar by D Prasad, MD.

6. Immobilization: distribution of methods utilized
Per number of metastases

7. Fractionation: Distribution of number of fractions

8. Icon increases patient volume
Incremental volumes reported of up to 25% with LGK Icon compared to Perfexion.
Increased volume includes cases not possible to treat with Perfexion:
Fractionation preferred because of:
Target volume
Abutting critical structures
Avoid repeat fixed frame fit
Patient refuses frame

9. Icon opens up new types of treatments
New treatment paradigms with an adaptive, mask-based approach range from single session treatments and hypo-fractionation to full fraction schemes
Case report*
Adaptive fractionated stereotactic Gamma Knife radiotherapy of meningioma using integrated stereotactic cone-beam-CT and adaptive re-planning (a-gkFSRT)
Examples of treatment regimens as reported
Pituitary
in 25# (fractions)
Vestibular Schwannoma
50Gy in 25#
Meningioma (contacting optic nerve/chiasm)
in 5#
Meningioma 31 cc
in 5#
Metastasis 16 cc
in 5#
Metastasis 14 cc
in 3#
Metastasis (contact with optics)
and in 5#
76 yr old female
Benign meningioma, WHO grade I, located at left petrous bone. Volume cm3
Hypofractionated mask-based treatment. 5x 5 Gy to GTV, to preserve the acoustic and facial nerve.
Adaptive daily re-plan
Outcome:
Adaptive daily re-planning was accurate and yielded quality measures, e. g., coverage, selectivity, and gradient for the delivered dose identical to the initial values
Treatment well tolerated (slight headache after 1st treatment resolved with dexamethasone)
Follow-up at 6 weeks and 4 months: no neurological symptoms
* Stieler F, Wenz F, Abo-Madyan et al. Strahlenther Onkol July 2016.

10. Over 1,000,000 patients treated with LGK
Over 1,000 Icon treatments have been reported through July, 2016.
Source: Leksell Gamma Knife Society, Annual Treatment Statistics 2015

11. 17 LGK Icon sites in clinical use
July 21, 2018
17 LGK Icon sites in clinical use
Status: September 2016