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.
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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:
·
a radiation oncologist
·
a neurosurgeon
·
a medical physicist
·
a radiation therapist
·
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.
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.
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