Initial Experience with Novel Self-shielding, Gyroscopic Radiosurgery: First 150 Patients

Introduction: The ZAP-X ® Gyroscopic Radiosurgery System is unique regarding self-shielding capability and offers a variety of improvements over traditional linear accelerator systems used for SRS. We report our initial experience with the first 150 patients treated with this new advancement in gyroscopic radiosurgery.

Methods: All patients were treated using the ZAP-X Gyroscopic Radiosurgery Platform at Jersey Shore University Medical Center. Patient demographics as well as treatment characteristics including dosimetry and side effects were collected and analyzed. Patient comfort and satisfaction was gauged with a post-operative questionnaire which utilized a 5-point Likert scale.

Results: 150 patients were treated using the ZapX Gyroscopic Radiosurgery System from October 2023 to October 2024. There were 158 treatments in total, comprised of 77 cases of brain metastases, 37 meningiomas, 13 trigeminal neuralgias, 9 schwannomas, 8 recurrent glioblastomas (GBM), 7 pituitary adenomas, 3 spinal tumors, 3 arteriovenous malformations (AVMs), and 1 hemangioma. Linear regression revealed a decrease in treatment times over the course of several months, with an average treatment time of 51 minutes. The median treatment dose was 24 Gy, and the median prescription isodose line was 60%. The most common side effect was fatigue (71%) and the least common were tinnitus and visual disturbance with a single occurrence each (1.6%). Patient experience metrics were extremely favorable; the average overall rating of care was 4.96 and the mean patient level of comfort during Zap-X treatment was 4.38.

Conclusion : Our initial experience with the use of Zap-X demonstrated excellent utility in the treatment of various neurosurgical conditions along with strong patient satisfaction with the treatment. Further treatment data and long term follow-up is needed to determine its effectiveness as a therapy option for patients.