The CyberKnife is a robotic stereotactic radiosurgery system that achieves
surgical like results using highly
focused radiation to kill benign or malignant tumors. The system consists of a
compact linear accelerator
mounted on a robotic arm. It is controlled by computers and guided by real-time
x-ray images throughout
the delivery of high dose radiation. The robotic system is able to detect and
adjust for minute changes in
patient or target position, even locking on to a target that moves during
WHAT DISEASES DOES CYBERKNIFE TREAT?
CyberKnife treats tumors and benign lesions of the brain, spine and soft
tissue in areas such as lung, liver,
pancreas and prostate. Primary and metastatic tumors as well as functional
diseases, such as arterial
venous malformations (AVM’s) and trigeminal neuralgia, can be treated by
WHEN IS CYBERKNIFE STEREOTACTIC RADIOSURGERY AN APPROPRIATE TREATMENT
Radiosurgery is not an appropriate treatment option for every patient or
disease. CyberKnife is appropriate
whenever stereotactic radiosurgery is appropriate. CyberKnife stereotactic
radiosurgery is often used in
conjunction with traditional therapies such as radiation therapy, chemotherapy
or surgery. CyberKnife
may also be the best, or the only, option for some patients in the following
- recurrence of a tumor next to a critical structure such as the spine, that has
already received its
maximum lifetime dose of radiation
- tumor located close to a critical structure such as optic nerves, where
traditional radiation therapy
would pose significant risk of damage to that structure
- when a surgical approach would be too difficult
- when surgery is unable to remove all of the diseased tissue
- when the patient is unable or unwilling to undergo traditional surgery.
WHAT IS INVOLVED WITH A CYBERKNIFE TREATMENT?
The patient and their primary care physician may seek a CyberKnife
consultation with the CyberKnife
clinical team. Every consultation includes the CyberKnife radiation oncologist
and surgeon. If treatment
is appropriate, the CyberKnife coordinator arranges for imaging studies from
which the CyberKnife
surgeon, radiation oncologist and physicist jointly plan and approve a course of
treatment. The treatment is
completed in 1 to 5 sessions lasting 45 to 90 minutes.
IS A CYBERKNIFE TREATMENT LIKE RADIATION THERAPY?
Although both methods use high energy radiation, stereotactic radiosurgery
differs from traditional
radiation therapy or intensity modulated radiation therapy in several ways.
CyberKnife treatments are
more accurate due to the ability of the robot to point to the target from more
than 1,000 possible positions
with sub millimeter precision. This means that the target can be fully treated
while minimizing radiation to
immediately adjacent structures. High accuracy enables a full treatment in 1 to
5 sessions rather than 25 to
CyberKnife is “patient centric” meaning that the system finds and then adjusts
itself to the location of the
patient and tumor. There is a much wider variety of treatment angles and fields
for the computer to choose
from. Gamma Knife radiosurgery and linear accelerator (gantry) based treatments
meaning that the target must be brought into the center or focal point of the
treatment device. A rigid head
frame is required for gantry based or Gamma Knife radiosurgery, which is
confined to targets within the
brain. CyberKnife does not require the use of a rigid frame so targets can be
treated throughout the body.
WHAT ARE THE ADVANTAGES AND LIMITATIONS OF CYBERKNIFE?
CyberKnife achieves surgical like results without open surgery. Hence there
is no anesthesia, no blood
loss, and no post-surgical recovery. Patients typically resume normal activity
on completion of the
procedure. CyberKnife stereotactic radiosurgery is appropriate wherever
radiosurgery is indicated. Historically, stereotactic radiosurgery has been
confined to intracranial lesions.
The clinical literature for soft tissue radiosurgery is being developed, as
CyberKnife is the first technology
that is able to perform this type of treatment beginning in 2001.
WHY DID UNITED HEALTH SERVICES DECIDE TO INITIATE A CYBERKNIFE PROGRAM AT
WILSON MEMORIAL REGIONAL MEDICAL CENTER?
As a leader in bringing world class technology and medicine to the Southern
Tier, United Health Services
was eager to acquire CyberKnife technology for its patients. Our first patient
treatments on September 21,
2005 marked the culmination of nearly 3 years of planning, facility construction
and training of a clinical
team comprising radiation oncologists, surgeons, physicists, radiation
therapists and nursing staff. We are
proud to be the first CyberKnife center in New York State and part of a small
but rapidly growing number
of centers in the United States and overseas.
As with all medical devices, CyberKnife underwent FDA (Food and Drug
Administration) review and
received clearance in 2001 “to provide treatment planning and image guided
stereotactic radiotherapy for
lesions, tumors and conditions anywhere in the body when radiation treatment is
indicated”. To date,
thousands of patients worldwide have been treated with CyberKnife.