How the CyberKnife System Treats Brain Cancer

The CyberKnife Robotic Radiosurgery System improves on other radiosurgery techniques by eliminating the need for stereotactic frames. As a result, the CyberKnife System enables doctors to achieve a high level of accuracy in a non-invasive manner and allows patients to be treated on an outpatient basis. The CyberKnife System can pinpoint a tumor’s exact location in real time using X-ray images taken during the brain cancer treatment that reference the unique bony structures of a patient’s head.

The CyberKnife System has a strong record of proven clinical effectiveness.  It is used either on a stand–alone basis or in combination with other brain cancer treatments, such as chemotherapy, surgery or whole brain radiation therapy.

CyberKnife brain cancer treatments involve a team approach, in which several specialists participate. The team may include:

1. ·         a radiation oncologist
2. ·         a neurosurgeon
3. ·         a medical physicist
4. ·         a radiation therapist
5. ·         other medical support staff

Once the team is in place, preparations begin for the CyberKnife treatment. Generally there are three steps involved:

1.     Set up and imaging

2.     Treatment planning

3.     CyberKnife treatment

Unlike other radiosurgery systems, the CyberKnife System does not require patients to be fitted with an invasive head frame. In the set-up stage, the radiation therapist will create a soft mesh mask that is custom-fitted to the patient’s face. This comfortable and non-invasive mask helps the patient keep his or her head and neck still during treatment. While wearing the mask, a CT scan will be performed. The CT data then will be used by the USC CyberKnife team to determine the exact size, shape and location of the tumor.

An MRI, PET scan or angiogram also may be necessary to fully visualize the tumor and nearby anatomy. Once the imaging is done, the face mask will be removed and stored until the CyberKnife treatment begins. Then a medical physicist and the patient’s doctor use the data to custom-design the patient’s treatment plan. The patient does not need to be present at this time.

During the CyberKnife treatment planning phase, the CT, MRI and/or PET scan data will be downloaded into the CyberKnife System’s treatment planning software. The medical team will determine the size of the area that must be targeted by radiation and the radiation dose. They also will identify critical structures where radiation should be minimized. Using this information, the CyberKnife System calculates the optimal radiation delivery plan to treat the tumor. The treatment plan will take full advantage of the CyberKnife System’s extreme maneuverability, allowing for a safer and more accurate treatment.

After the brain cancer treatment plan is developed, the patient will return to USC Norris Cancer Hospital for the CyberKnife treatment. The doctors may choose to deliver the treatment in one session, or stage it over several days. Typically, brain cancer treatments are completed within five days. For most patients, the CyberKnife treatment is a completely pain-free experience. Patients dress comfortably in their own clothes and may bring their own music CD's to listen to during the treatment. Patients also may want to bring something to read while they wait, and have a friend or family member with them to provide support before and after treatment.

When it is time for treatment, the patient lies on the table while their custom-fitted face mask is secured into place. The CyberKnife System’s computer-controlled robot will move around the patient’s body to the various locations from which it will deliver radiation to the tumor. Nothing will be required of the patient during the treatment, except to relax and lie as still as possible.

Once the CyberKnife treatment is complete, most patients quickly return to their daily routines with little interruption in their normal activities. If the treatment is being delivered in stages, the patient will need to return for additional treatments over the next several days, as recommended by their doctors. Side effects vary from patient to patient. Generally some patients experience minimal side effects from CyberKnife treatments, and these often go away within a week or two. Prior to treatment, the doctor will discuss with the patient all possible side effects they may experience. The doctor also may prescribe medication designed to control any side effects should they occur.

After completing CyberKnife radiosurgery treatment, it is important that the patient schedule and attend follow-up appointments. They also must keep in mind that their tumor will not suddenly disappear. Response to treatment varies from patient to patient. Clinical experience has shown that most patients respond very well to CyberKnife treatments. As follow-up, doctors will monitor the outcome in the months and years following a patient’s treatment, often using either CT scans and/or PET-CT scans.4

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How is a CyberKnife Radiosurgery is different from a Traditional Radiation Therapy Treatment

Whatis the CyberKnife System?

The CyberKnife® Robotic Radiosurgery System is a non-invasive alternative to surgery for the treatment of both cancerous and non-cancerous tumors anywhere in the body, including the head, spine, lung, prostate, liver and pancreas.  The treatment – which delivers beams of high dose radiation to tumors with extreme accuracy – offers new hope to patients worldwide.

Though its name may conjure images of scalpels and surgery, the CyberKnife treatment involves no cutting. In fact, the CyberKnife System is the world’s first and only robotic radiosurgery system designed to treat tumors throughout the body non-invasively.  It provides a pain-free, non-surgical option for patients who have inoperable or surgically complex tumors, or who may be looking for an alternative to surgery.

What can the CyberKnife System treat?

The CyberKnife® System is a non-invasive alternative to surgery for the treatment of both cancerous and non-cancerous tumors anywhere in the body, including the head, spine, lung, prostate,  liver and pancreas.  The treatment – which delivers high doses of radiation to tumors with extreme accuracy – offers new hope to patients who have inoperable or surgically complex tumors, or who may be looking for a non-surgical option. To date, more than 100,000 patients have been treated and 244 systems are installed worldwide.

Below is a list of some tumors and lesions that can be treated by the CyberKnife System:

• Osteosarcoma
• Nasopharyngeal carcinoma
• Squamous cell carcinoma
• Non-small cell lung cancer
• Small-cell lung cancer
• Pancreatic cancer
• Hepatocellular carcinoma
• Prostate cancer
• Renal cell carcinoma
• Colon cancer
• Ovarian cancer
• Uterine cancer
• Arteriovenous malformation (AVM)

The CyberKnife combines a linear accelerator, robotic arm and image guidance system. The flexibility of the robotic arm allows the CyberKnife to precisely target lesions in areas of the body unreachable by other means. The CyberKnife also is unique in its ability to continually monitor and adjust in near real-time for changes in target location during treatment. Finally, unlike most other stereotactic radiosurgery systems, the CyberKnife is able to locate and treat lesions in the head or neck without the use of an invasive head frame.

There are numerous patient benefits to the CyberKnife system, including:

• Non-invasive treatment—no head frames affixed to the skull
• No anesthesia
• No recovery time
• Surgically precise targeting (sub-millimeter clinical accuracy)
• 100% frameless
• Minimal effects to surrounding critical tissues
• Robotics adjust to compensate for patient movement
• Flexible treatment planning; image acquisition scheduled around the patient’s availability
• Complements existing St. Joseph’s radiosurgery technologies
• Treatment is typically outpatient, with just one to five treatment days required
• Suitable for treatment of many tumors or lesions throughout the body, including soft tissue, spinal, head and neck and intracranial cases
• Appropriate treatment for some patients diagnosed with inoperable or untreatable tumors or other lesions

CyberKnife radiosurgery treatment vs traditional radiation therapy treatment?

Traditional radiation therapy typically delivers radiation to a wide field of tissue in the body resulting in the treatment of both the tumor and a large amount of surrounding healthy tissue. This is necessary because traditional radiation therapy systems did not account for tumor motion and were therefore much less accurate. These wide radiation fields increased the possibility of damage to normal tissue, increasing the risk of side effects following the radiation treatment. To reduce the number of side effects, clinicians were forced to rethink the way traditional radiation therapy was delivered. As a result, the overall radiation dose was reduced and the number of treatments was divided into 30 to 40 sessions, delivered over a period of weeks.

Radiosurgery devices, such as the CyberKnife Robotic Radiosurgery System, were designed to deliver radiation with extreme accuracy, targeting the tumor with minimal damage to the surrounding healthy tissue.  The accuracy of the CyberKnife System allows clinicians to deliver very high doses of radiation safely because the size of the radiation field is smaller and only includes the tumor and a small amount of surrounding tissue.  This allows for less damage to surrounding healthy tissue and for clinicians to complete treatment in 1 to 5 days vs. the weeks it takes traditional radiation therapy.

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Advantages of CyberKnife Radio Surgery in India

Cyberknife surgery in India

Cyberknife is the world's first and only robotic radiosurgery system which treats tumours anywhere in the body without any surgery. Though it is called Radiosurgery or Cyberknife- No knife is used for incision and no surgery is performed to treat the tumours. A new hope for patients who have inoperable or surgically complex tumors, or who may be looking for a non-surgical option. Cyberknife radiosurgery is a non –invasive, high-energy radiation treatment that delivers very precise beams of radiation from many angles outside the body. The accuracy of Cyberknife is so precise that radiation can be 'matched' to the shape of small complex tumors, even those located near critical organs. This ability allows Cyberknife to treat many lesions including some considered inoperable or untreatable with surgery.

 The CyberKnife Robotic Radiosurgery System treats both cancerous and non-cancerous tumors anywhere in the body, including the prostate, lung, brain, spine, liver, pancreas and kidney.It provides a pain-free, non-surgical treatment to the patients with complex tumours which are un operable or too risky to be operated and to the patients who are looking for an alternative to surgery. To date, more than 100,000 patients have been successfully treated and more than 150 systems are installed worldwide.

Cyberknife Treatment Procedures

Cyber knife treatment works in mainly two ways. In the first methodology, lightweight radiation delivery equipment is inserted on a multi-jointed robotic arm, so that it can be easily reach tumors in any part of the body. In the second method, the technique uses image guidance system, which allows the Cyberknife therapy to track and allocate the tumor.

CyberKnife uses image guidance and robotics to maintain a high degree of precision and is particularly useful for tumors that are close to critical structures.

The biggest advantages which the Cyber knife treatment offers are that no anesthesia is required, no hospitalization and no cuts or incisions at all. This means that there is no recovery time and everyday activities can be resumed immediately. Also, the treatment is undertaken in 1 to 6 sessions, which can be performed on either the same day or different days, as per the patient's convenience.

What does Cyber knife Surgery Treat?

The Cyberknife system has FDA clearance for treatment of tumors in any location of the body. Cyberknife surgery is administered for both cancerous and benign tumors. All stages, from I until IV (metastases) can be treated. Following are treated using Cyberknife system:

• Cancers involving the brain
• Lung cancers
• Pancreatic cancers
• Metastatic liver cancers
• Cancers involving the spine
• Benign brain tumors
• Malformations of blood vessels within the brain
• Trigeminal neuralgia
• Metastatic orbital tumors, orbital lymphomas and orbital inflammations (tumors or inflammations around the eye)

Advantages of CyberKnife Radio Surgery Over Other Radio surgery Methods

• The CyberKnife system is able to locate tumors within the body without the use of an invasive stereotactic headframe used with other systems. This is much more convenient and less traumatic for patients.
• While other forms of radiosurgery can only treat tumors in the head, Cyberknife can treat tumours anywhere in the body- brain, spine, liver, lungs, pancreas, kidney or prostrate.
• While other forms of radio surgery treatment techniques need rigid head-frames screwed to the patient's head for controlling movement, which is painful and cumbersome for the patient, CyberKnife does not require such extreme procedures to keep patients in place, and instead relies on sophisticated tracking software, allowing for a much more comfortable and non-invasive treatment.
• The CyberKnife System can essentially "paint" the tumor with radiation allowing it to precisely deliver treatment to the tumor alone, sparing surrounding healthy tissue.

Cyberknife Cancer Treatment in India: A New Hope for Patients

There was a time, when cancer patients from India were flying to other countries for their treatment but thanks to hospitals in India, which has introduced the most advanced Cyberknife Radio Surgery System in Asia Pacific, things are now the other way around. Now, cancer patients from all across the world can receive Cyberknife cancer treatment in one of India's best hospitals.

Cyberknife surgery in India is offered at a greatly reduced costs. But this does not mean a compromise on the quality at all. Also, due to the reduced costs, patients can opt for a longer hospital stay. When going in for a Cyberknife treatment in India, there is one thing which you should keep in mind. Hospitals in India usually require a PET CT scan reports or MRI images before they can provide an estimate and accept the patient.

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