CyberKnife is a robotic radiosurgical device that is used for the treatment of malignant and benign neoplasms. It is especially suitable for treating tumours in hard-to-reach places such as the brain and spinal cord, mobile organs and other tissues. The procedure is non-invasive and safe, has almost no contraindications and is accompanied by minimal side effects.
Radiosurgery is a method of local irradiation of pathological foci (lesions), inaccessible to surgical intervention or treatment of tumour recurrences after surgery. The treatment is performed without traditional surgical access, anaesthesia and severe disorders that accompany almost every neurosurgical operation.
The principle of various radiosurgical devices is approximately the same: they focus the beams on the targeted area with millimetre accuracy. But the capabilities of the devices are different. For more complex localisations, especially in treating tumours near critical brain structures (optical nerves, cranial nerves, brain stem), and neoplasms of the spine, spinal cord and internal organs, the Cyberknife is the best option.
CyberKnife robotic stereotaxic radiosurgery is a high-precision modern technology that treats malignant and benign tumours in various body parts. It does not require surgical intervention and is painless, which allows the patient to return to the usual rhythm of life quickly.
The machine includes a linear accelerator that generates radiation and a device that sets its direction. In addition, some cameras allow doctors to get an X-ray image of the cancerous organ from different angles and change the direction of the radiation beam depending on the findings.
Radiosurgery is usually used as an alternative to surgery or classical radiation therapy or as the only treatment option for patients with oncological and benign conditions.
Steps of CyberKnife
The course of treatment on the CyberKnife machine consists of 4 stages.
- The first is preparation, which takes 1-2 days. Radiologist assistants individually create a thermoplastic mask or vacuum mattress for the patient. The specialist conducts CT and MRI scans for treatment planning.
- The second stage, which lasts from 1 to 3 days, is planning and checking the treatment plan. It is carried out by a radiation therapist and a specialist in medical physics. Doctors determine the most effective and safe radiosurgical treatment dose at this stage.
- The third stage is the CyberKnife treatment procedure (1-5 days). Assistant radiologists carry it out under the supervision of a radiation therapist. In the treatment room, the doctor helps you to lie down on a unique table, puts on a thermoplastic mask, and then the treatment begins. The duration of the procedure is about an hour. There are no unpleasant sensations during the treatment, and you can even turn on your favourite music. During the session, the CyberKnife robot moves around the patient, affecting the tumour.
- The final stage is recovery. Patients are given symptomatic treatment and guided to have repeated scans to track tumour activity.
CyberKnife applications (where is used?)
Radiosurgery using the CyberKnife system is indicated for patients with benign and malignant (including metastases) brain neoplasms:
- Benign brain tumours (neuroma, meningioma, pituitary adenoma);
- Pathological formation of blood vessels in the brain;
- Separate (1-4, up to 10) metastases;
- Malignant neoplasms in the brain;
- Trigeminal neuralgia;
- Tumours of the eyes (meningioma of the membranes and glioma of the optic nerve);
- Tumours of the head and neck region (primary cancer of the throat and vocal cords);
- Some forms of parkinsonism.
The doctors also successfully use the system to treat neoplasms of the spine and spinal cord, tumours and metastases of internal organs (lungs, liver, pancreas, kidneys, prostate cancer, uveal melanoma).
Thus, with the device's help, radiosurgery can be performed at almost any point of the body, of course, in those situations where it is indicated.
One of the main advantages of CyberKnife is the high accuracy of irradiation. It purposefully affects the tumour with a powerful radiation flow, almost without damaging healthy parts of the organ. As a result, CyberKnife effectively treats cancer with metastases, an alternative to chemotherapy and hormone therapy.
Radiosurgery is one of the most modern and safe procedures to treat cancer. The system allows you to quickly and painlessly get rid of oncology. A typical session last from 30 minutes to two hours. Usually, a course of therapy might include several sessions.
CyberKnife is effective in treating neoplasms up to 4 cm in diameter. The device is often used to remove meningiomas near the optic nerves - thanks to the high precision, it is much safer than traditional surgery.
The undoubted advantage of this procedure is that it is entirely non-invasive and does not require anaesthesia. General anaesthesia has many contraindications, including myocardial infarction, bronchial asthma, hormonal diseases, and heart failure. However, this does not apply to radiosurgery. In addition, this method of treatment has minimum complications and is painless.
During the procedure, a light mesh mask for the head or a vest for the body is used, which allows you to breathe and move freely. CyberKnife machine takes into account even the minimal movements of the patient during the procedure and adapts to them. Therefore, the patient can relax and breathe freely.
Possible complications after CyberKnife surgery
Radiosurgery has significantly fewer side effects than conventional radiation therapy or chemotherapy. Side effects include general weakness and dizziness, which pass after a few days. The rehabilitation course after treatment is minimal; in some cases, it is not needed.
The main contraindications are the large size of the tumour (more than 4-5 cm in diameter), brain dislocation (displacement of brain structures due to trauma) or even suspicion of any dislocation syndrome. In addition, the CyberKnife is not used in case of decompensation (a malfunction of an organ or system).
Recovery after CyberKnife treatment
The entire course of treatment on CyberKnife, together with preparation, can be completed in 5-10 days. It is much shorter than conventional radiation therapy (3-5 weeks) or surgery (2-3 weeks).
The procedure is painless and takes about an hour. Right after that patient can freely walk or rest. The next day, after the course of treatment, you can go home and return to everyday life.
What is the difference between traditional radiotherapy and CyberKnife?
With traditional radiotherapy, radiation usually affects a wide area. So it leads to irradiation of both the tumour and a large number of surrounding healthy tissues. In contrast to such a therapy, the CyberKnife robotic radiosurgery system performs irradiation with maximum accuracy, guaranteeing minimal damage to the surrounding organs. In addition, the precision of the technique allows doctors to deliver very high doses of radiation safely.
What is the success rate of CyberKnife?
The effectiveness of radiosurgical treatment for meningioma, neurinoma of the auditory nerve and pituitary adenoma is 98-100%. When treating single (1-4, sometimes up to 10) metastases, local control is achieved in 85-95% of cases, with the proven advantage of preserving the patient's quality of life.
What cancer types can be treated with CyberKnife?
The main indications for treatment are brain metastases, tumours of the spinal cord (including metastases), tumours lesions of the oral cavity, eye socket, nasopharynx, larynx, auditory nerve, pituitary gland, carotid sinus neoplasm, cancer and metastases in the liver, lungs, pancreas, reproductive system, kidneys, prostate, and retroperitoneal space, recurrent manifestations of neoplasms of the head and neck.
Is CyberKnife more advanced than radiation?
The CyberKnife works with a higher single, lower total dose and usually a shorter treatment time than radiation. It always hits exactly the tumour - the healthy tissue is optimally protected. A precision robot places the radiosurgical dose from many directions in the tumour with pinpoint accuracy. CyberKnife treatment allows doctors to complete treatment within 1-5 days instead of 6-8 weeks, as with traditional radiation therapy.
What is the maximum size of the tumour suitable for CyberKnife?
Depending on the location, the lesion to be treated should not exceed a specific size: ideally up to 3 cm, maximum up to 6 cm. Bigger tumours theoretically can be treated but cause massive intoxication in case they are too big. Therefore, doctors stick to the given numbers.
What are the best clinics for CyberKnife?
Who are the best doctors for CyberKnife?
Prof. Dr. med. Alexander Muacevic from European Radiosurgery Centre Munich
Prof. Dr. med. Claus Rodel from University Hospital Frankfurt am Main of Goethe-University
Prof. Dr. med. Robert Krempien from Helios Hospital Berlin-Buch
Dr. med. Otto Bundschuh from Radiotherapy and Gamma Knife Centre Hanover
Dr. med. Gerhard A. Horstmann from Radiotherapy and Gamma Knife Centre Krefeld
Price of CyberKnife
The cost of the treatment depends on the chosen tactics of radiosurgery, the required dose, the size of the tumour, the complexity of planning, the need for combined therapy and several other factors. Each case is unique in this aspect. Therefore, the specialists can find the more accurate cost of treatment with the CyberKnife radiosurgical system after checking your medical records.
The price varies from 7,000 $ to 21,000 $. This estimation may also include preliminary diagnostic procedures (X-ray, MRI, laboratory tests) that every patient must complete before starting treatment.