Gamma tile is a postage stamp-sized collagen tile that is placed in the brain after tumor surgery to deliver radiation therapy. Gamma tile reduces the risk of tumor recurrence while also protecting healthy brain tissue during treatment and reducing side effects of radiation therapy, including hair loss.
Denver neurosurgeon Dr. Angela Bohnen, FAANS, with Neurosurgery One now offers GammaTile Therapy® for patients diagnosed with glioblastomas, recurrent meningiomas, and brain metastases. Dr. Bohnen performs this procedure at Littleton Adventist Hospital in Littleton, Colo.
At Neurosurgery One, we provide the latest medical device advancements and treatment options to enhance the lives of our patients. We strive to deliver the best outcomes and highest value of service through compassion, reliability, innovation, and excellence. We are proud to offer GammaTile Therapy, the latest FDA-cleared device for the treatment of operable brain tumors.
A Guide to Gamma Tile Radiation Therapy
In this guide, we will explore gamma tile, the newest form of radiation therapy for benign and malignant brain tumors. This guide to GammaTile Therapy covers:
- What is gamma tile?
- How does radiation help treat brain cancer?
- How does gamma tile radiation work?
- How successful is gamma tile radiation therapy for brain cancer?
- What are the benefits of gamma tile?
- Gamma tile vs. EBRT:
- Gamma tile vs. brachytherapy:
- Does gamma tile radiation hurt healthy brain tissue?
- Who can benefit from gamma tile therapy?
- What are the side effects of gamma tile therapy?
- What is the cost of gamma tile therapy?
What is gamma tile?
GammaTile Therapy is Surgically Targeted Radiation Therapy (STaRT) and features a bioresorbable, conformable, 3D-collagen tile and uniformly spaced radiation sources. Each gamma tile is about the size of a postage stamp. It is placed in the brain during surgery to remove the brain tumor. Gamma tile radiation therapy immediately begins targeting tumor cells in the area where they are most likely to grow. Over time and after the radiation has been delivered, the body naturally absorbs the tile. GammaTile Therapy can extend patients’ lives, reduce complications, and improve quality of life.
How does radiation help treat brain cancer?
Radiation therapy uses x-rays or other particles to damage the DNA of tumor cells. When the DNA is damaged in a way that the body cannot repair, the cells die or they lose the ability to stop dividing and growing new cells. When damaged calls die, they break down and naturally leave the body. Radiation therapy takes days or weeks to damage the DNA enough to kill the cancer cells and it continues to work after the radiation stops.
How does gamma tile radiation work?
Gamma tile radiation therapy kills tumor cells in the same way as other forms of radiation therapy, but the radiation therapy is delivered differently. GammaTile Therapy starts immediately at the time of surgery. After Dr. Bohnen has safely removed as much of the brain tumor as possible, she places gamma tiles into the brain, covering the tumor cavity with tiles. The number of tiles used will depend on the size and location of the tumor. It takes approximately 5 minutes to place the tiles at the end of tumor removal surgery prior to closing the incision.
According to a study, the gamma tiles immediately begin delivering a uniform radiation dose to the target area:
- 50% of the therapeutic dose is delivered within the first 10 days after surgery, which helps prevent residual tumor cells from replicating.
- 88% of the therapeutic dose is delivered within 30 days, with more than 95% of the dose delivered by 6 weeks.1
How successful is gamma tile radiation therapy for brain cancer?
Radiation therapy for brain tumors, including brain cancer, can cure some types of small non-cancerous (benign) brain tumors. It also can be successful in treating very slow-growing cancerous tumors. For larger or more fast growing malignant brain tumors, radiation therapy can help shrink or stop the growth of the tumor.
For patients with recurrent meningiomas and brain cancer metastases, a retrospective study and a prospective study demonstrated that patients receiving GammaTile Therapy experience a significant reduction in brain cancer recurrence, compared to their previous treatments.
In patients with recurrent glioblastomas (GBMs), GammaTile Therapy demonstrates a potential for improved overall survival when comparing the effectiveness of surgery plus GammaTile Therapy to other treatments across different clinical studies.
What are the benefits of gamma tile?
There are two main types of radiation therapy used to treat brain tumors: external beam radiation therapy (EBRT) and brachytherapy, which is delivered internally. Gamma tile treatment offers benefits over both forms of traditional radiation therapy for brain cancer and brain tumors.
Gamma tile vs. EBRT:
GammaTile Therapy offers significant advantages over EBRT. Gamma tile treatment begins immediately and doesn’t require multiple treatments. With external beam radiation therapy, patients must wait 2 to 3 weeks after surgery to begin radiation therapy. During this time, residual tumor cells can begin to replicate and the tumor can regrow. Patients also must typically undergo external radiation therapy 5 days a week for 3 to 6 weeks, for a total of 15 to 30 sessions. In contrast, gamma tile radiation therapy is implanted at the time of surgery, allowing patients to return to their normal daily lives while receiving radiation.
GammaTile Therapy also minimizes typical radiation side effects, including hair loss. In a clinical study, only 1 out of 74 patients experienced hair loss after being treated with GammaTile.
Gamma tile vs. brachytherapy:
Gamma tile and brachytherapy are both forms of internal radiation. Internal radiation provides several benefits including:
- Reduced damage to normal tissue
- Reduced side effects
- More concentrated delivery of radiation to the area where the cancer is mostly likely to recur
- Increased convenience for patients and caregivers
Like gamma tile, brachytherapy is placed within the tumor cavity during surgery. However, the dose can be extremely high around the radiation source and can cause serious side effects, including swelling and damage to healthy brain tissue. GammaTile Therapy is different from traditional brachytherapy because the collagen tile containing the radiation provides a buffer, allowing the patient to receive the optimal dose of radiation while also reducing damage to healthy brain tissue.
Does gamma tile radiation hurt healthy brain tissue?
Because GammaTile Therapy is targeted and delivered directly to the tumor site, patients receive a therapeutic dose of radiation specifically – and only – where it is needed, protecting healthy brain tissue. Over time, the therapeutic dose of radiation is delivered, and the collagen tile is naturally absorbed by the body. Eventually, only the small, inactive titanium sources that once held the radiation remain. This helps protect healthy brain tissue as patients receive a lower overall level of radiation exposure to healthy tissue, according to a study published in the Journal of Neurosurgery.
Who can benefit from gamma tile therapy?
The latest advancement in brain tumor treatment, GammaTile Therapy is FDA-cleared to treat patients with newly diagnosed malignant and recurrent brain tumors.
What are the side effects of gamma tile therapy?
Most gamma tile patients experience fewer side effects than patients who have received other radiation treatments.1–2, 6 Some patients who receive gamma tile therapy may experience postoperative side effects, including nausea, vomiting, headache, sleepiness, neurodeficit, seizures, and skin irritation.
The risk of adverse events related to radiation exposure vary depending on the radiosensitivity of the exposed tissue, the amount of radiation delivered, and the placement of the gamma tiles. Dr. Bohnen and her team will work closely with you prior to treatment to explain any potential side effects, how those are treated, and ensure that you are completely comfortable with the therapy.
What is the cost of gamma tile therapy?
GammaTile Therapy is covered by most insurance plans, including Medicare and Medicaid.
Brachman D, Youssef E, Dardis C, et al. Surgically targeted radiation therapy: safety profile of collagen tile brachytherapy in 79 recurrent, previously irradiated intracranial neoplasms on a prospective clinical trial. Brachytherapy. 2019;18(3):S35-S36.
Nakaji P, Smith K, Youssef E, et al. Resection and surgically targeted radiation therapy for the treatment of larger recurrent or newly diagnosed brain metastasis: results from a prospective trial. Cureus. 12(11):1-12.
Choi M, Zabramski J. Re-Irradiation using brachytherapy for recurrent intracranial tumors: a systematic review and meta-analysis of the literature. Cureus 12(8): e9666. doi:10.7759/cureus.9666.
Nakaji P, Youssef E, Dardis C, Smith K, Pinnaduwage D, Brachman D. Surgically targeted radiation therapy: a prospective trial in 79 recurrent, previously irradiated intracranial neoplasms. Poster presented at: 2019 AANS Annual Scientific Meeting; April 2019; San Diego, CA.
Brachman D, Youssef E, Dardis C, et al. Resection and permanent intracranial brachytherapy using modular, biocompatible cesium-131 implants: results in 20 recurrent, previously irradiated meningiomas. J Neurosurg. 2019;131(6):1819-1828
Indication: GammaTile is intended to deliver radiation therapy in patients with newly diagnosed malignant intracranial neoplasms and recurrent intracranial neoplasms. Side effects related to GammaTile Therapy are rare and may include radiation brain changes including necrosis. Refer to the instructions for use for a complete description of all warnings, precautions, and contraindications.
This page was reviewed by Dr. Angela Bohnen, MD, FAANS, a board-certified Denver neurosurgeon with Neurosurgery One.