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Gamma knife before or after craniotomy? Radiation seeds?

Forums General Melanoma Community Gamma knife before or after craniotomy? Radiation seeds?

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    lkb
    Participant
      My neurosurgeon recommends surgical removal of a brain met plus (not instead of) gamma knife. He also mentioned a pre-op gamma knife clinical trial, but I’m guessing this would distort the diagnostic offering of surgery (measuring tumor v. ipi-nivo treatment effects). If post-op, would gamma knife impair the incision healing? He also mentioned “hot” radiation seeds inserted during surgery, but seems to favor radiation coming from without. I’m wondering how to decide the order of business for craniotomy + gamma knife? Radiation seeds?
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        JudiAU
        Participant
          I’ve had radiation used twice after craniotomies, once for a melanoma met and another time for my actual brain tumor that had a tiny bit of growth. In both cases it was to deal with the small scraps that of tumor or cancer that is left behind and the surgeon can’t get. Neither was a big treatment just 2-4 sessions and not the big radiation sessions you hear described. The radiation is sort of like clean up. I don’t know anything about radiation pearls. Sounds horrible. Usually the oncologist and radiologist work as a team to schedule the best approach for a particular met.
            lkb
            Participant
              Thank you, JudiAU. I’m hoping that if I have the craniotomy, the radiation will be a simple follow-up. The surgeon said the radiation coming from the outside was less risky than implanting “seeds” during the surgery.Yes, they do have a menacing sound to them, though I initially liked the idea of avoiding one more separate procedure.
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