OrthoNeuroSpine & Pain Institute

Cyberknife is described as a form of radiosurgery. What is radiosurgery?

Radiosurgery is NOT surgery - rather, it is a form of radiation therapy which is extremely precise, like surgery. Because it is so precise, it can deliver enormously high doses of radiation to tumors while keeping the dose to surrounding normal tissues very low. This enables the delivery of much higher doses to tumors over a much shorter period of time (compared to traditional radiotherapy), producing a much greater destructive effect on the tumor. No surgery is actually performed, but the tumor is ablated (destroyed) so thoroughly that the effect is often similar to having it surgically removed. The key aspect of radiosurgery is administering a HIGH DOSE OF RADIATION OVER A SHORT PERIOD OF TIME (usually 1-5 days), made possible by the extremely low doses to nearby normal tissues. This is called “hypofractionation”, and the success of radiosurgery at eradicating tumors is a direct consequence of this dosing schedule.

CyberKnife and other radiosurgery procedures are often referred to as Stereotactic Radiosurgery (SRS) or Stereotactic Body Radiotherapy (SBRT) - what do these mean?

SRS and SBRT are conventional terms which simply mean radiosurgery delivered to targets in the brain and spine (SRS) and to targets elsewhere in the body (SBRT). “Stereotactic” refers to the fact that a three-dimensional external positioning system is used to verify patient position and relate external landmarks to the internal location of the tumor target, to ensure targeting accuracy.

Is the CyberKnife® clinically proven?

The CyberKnife® System utilizes radiation technology that has been proven for over 30 years. Additionally, over 30,000 patients have received CyberKnife® treatments worldwide. There are many studies showing excellent results with CyberKnife treatment to various specific body sites.

What is the difference in Conventional Radiation Therapy vs. Stereotactic Radiosurgery?

Conventional radiation therapy (radiotherapy) administers a broad beam of radiation from one or two up to 7 or 8 directions through normal tissues and requires between about 10 and 40 treatments to complete. Stereotactic radiosurgery delivers highly focused beams from many directions, all intersecting at the tumor, so that the normal tissues receive much less radiation and the treatment can be completed in only one to five sessions.

How is Cyberknife different than other Stereotactic Radiosurgery Systems?

The CyberKnife, like other stereotactic radiosurgery systems, uses a linear accelerator (beam source) and image guidance. Unlike some other systems, CyberKnife image guidance is repeated throughout treatment delivery in order to compensate in real time for small changes in patient or tumor position, which is especially helpful for tumors that move with breathing. In addition, the Cyberknife utilizes a robotic arm that gives the system flexibility to reach areas of the body that are unreachable by other radiosurgery systems.

The Cyberknife system is able to locate tumors within the body without the use of an invasive stereotactic frame used with other systems. This is much more convenient and less traumatic for patients.

Is the CyberKnife® cleared by the FDA?

The CyberKnife® System received clearance from the FDA in July 1999 for the treatment of head and neck tumors. In October 2001, the FDA extended its clearance to include the treatment of tumors and other conditions anywhere in the body.

The Cyberknife received FDA clearance in April 2002 to market the state-of-the-art image guidance system that enables the Cyberknife system to continuously track, detect, and correct for tumor and patient movement throughout the treatment. A CE Mark for the Cyberknife System enabling distribution in the European community was received in September 2002.

Who will be involved during my treatment?

The CyberKnife® System utilizes a team approach where medical experts collaborate with the patient as their central focus. Team members may include your surgeon, radiation oncologist, radiologist, medical oncologist, physicist and other team members within the hospital.

What types of tumors can be treated?

The CyberKnife® System is cleared by the FDA for Full-Body Radiosurgery. Consult with your physician to see if the CyberKnife® Treatment is right for you.

Who Is A Candidate For Cyberknife

Arteriovenous malformation (AVM)

Acoustic Neuroma

Adrenal Tumors

Astrocytoma/Glioma/GBM

Bone Lesions

Chordoma

Craniopharyngioma

Hemangioblastoma

Liver

• Liver Mets
• Hepotocellular Cancer
• Cholangiocarcinoma

Lung

• Early Stage Primary Non Small Cell Lung Cancer
• Recurrence of Advanced-stage Non Small Cell Lung Cancer after prior treatment
• Lung Mets

Meningioma

Metastatic Tumors in any location

Nasopharynx

Oligodendroglioma/Medulloblastoma

Other Benign Tumors

Other Primary Tumors

Pancreas

Pelvic Tumors (prostate, colorectal, cervical, endometrial, sarcomas) recurring after primary treatment

Pituitary Adenoma (Cushing’s Disease)

Prostate

Renal Cell Cancers

Schwannoma

Spine

Trigeminal Neuralgia