Using the novel ZAP-X stereotactic radiosurgery technology, experts at Miami Neuroscience Institute and Miami Cancer Institute, both part of Baptist Health, now have another option to treat patients with a variety of brain tumors and disorders painlessly and without cutting through the skull. The therapy is only available at a handful of locations worldwide.

“Because we have every stereotactic radiosurgery modality in one location, we can individually match the patient to the technology that is best suited for them,” said neurosurgeon Michael McDermott, M.D., the Irma & Kalman Bass Endowed Chair in Clinical Neuroscience and the chief medical executive of Baptist Health Miami Neuroscience Institute.  “It’s giving patients better access to the care they need.” Stereotactic radiosurgery (SRS) is a non-invasive established treatment for many brain tumors.

From its appearance, the gyroscopic linear accelerator could almost be mistaken for a futuristic space capsule or a napping pod, but it actually delivers highly precise radiation with hundreds of angled radiation beams directed at the target in the brain, sparing nearby vital tissues. Its innovative, self-shielding design requires no heavily shielded and expensive vaults that house other types of radiation equipment and the healthcare team can be at the patient’s bedside safely.

“Normally there are doors that weigh a couple of thousand pounds between us and our patients. Here, we can sit right next to them, and we can treat benign and malignant brain tumors, primary or metastatic, in usually a few short treatments,” said radiation oncologist Rupesh Kotecha, M.D., chief of radiosurgery and director of the Central Nervous System Metastasis Program at Miami Cancer Institute.

The first patient treated with ZAP-X at Baptist Health was a 70-year-old Coral Gables woman with an asymptomatic meningioma, a non-cancerous tumor. Meningiomas, the most common type of tumor that grows in the head, are typically slow growing and appear in the membranes that surround the brain and spinal cord.

The woman had been closely monitored by doctors over several years. It was a combination of new growth of the tumor, and the patient’s desire to halt the tumor growth because she was dealing with other health problems, that drove the team to suggest the new treatment.

“She did very well,” Dr. McDermott said. “The sessions take about an hour, and afterwards she got back to life with no restrictions. The control rate for meningiomas with radiosurgery is 90 to 100 percent, 10 to 15 years post-treatment.”

The new technology requires most patients to undergo one to five treatments. Some conditions, such as trigeminal neuralgia may only need one session, Dr. McDermott said.

To prepare for the first session, patients undergo imaging studies that include MRI and CT scans. They are also fitted with a custom-made, pliable mesh face mask that helps keep their head in place during treatment. In addition, a simulation session ensures that everything is a go.

 “The technology is the first new radiosurgery platform developed in over 30 years,” said Minesh Mehta, M.D., John and Mary Lou Dasburg Endowed Chair in Radiation Oncology, Deputy Director and Chief of Radiation Oncology. “The precision and safety requirements of cranial radiosurgery with this new platform are excellent. We are excited that we can offer our patients the latest technology available and that we can tailor therapy to each patient individually.”

Among the conditions that can be treated with the new SRS platform are:

• Glioblastomas and gliomas
• Acoustic neuromas
• Meningiomas
• Cerebral arteriovenous malformations
• Brain metastases
• Trigeminal neuralgia
• Pituitary adenomas

Research into other potential uses is ongoing.

For best outcomes, a collaborative healthcare team with vast experience is required due to the complexities of caring for patients with brain tumors and other functional disorders. At Miami Neuroscience Institute and Miami Cancer Institute, neurosurgeons, radiation oncologists, medical physicists, radiation therapists and other specially trained employees work side by side.

ZAP-X was developed by John R. Adler, Jr., M.D., who also invented the CyberKnife Radiosurgery System. He is Emeritus Dorothy & TK Chan Professor of Neurosurgery and Radiation Oncology at Stanford University.

Because Baptist Health’s physicians are early adopters of the new technology and are providing input for future updates, the health system may become a training site for physicians from around the world. In addition, they will discuss their experience with the technology at Miami Cancer Institute’s Brain Symposium taking place in December 2024.