CyberKnife Information for Physicians

The CyberKnife System is the world’s first and only radiosurgery system designed to treat tumors anywhere in the body with sub-millimeter accuracy. Using image guidance technology and computer controlled robotics, the CyberKnife System is a form of Robotic Stereotactic Radiosurgery designed to continually track, detect, and correct for tumor and patient movement throughout the treatment.

CyberKnife Information for Physicians

Introduction | History | Benefits | Treatment | Comparison | Case Studies | Referring a Patient

 

Introduction to CyberKnife

CyberKnife works by delivering a series of high-dose radiation beams at varying points outside of the body. These beams are programmed to converge at one specific point — the tumor. Separately, the beams are not strong enough for the patient to incur any damage to healthy tissue as a result of the radiation therapy. But where the beams converge, the cancerous tissue is destroyed.  This technology can spare the tissue of vital organs near complex tumors of abnormal formation. CyberKnife’s robotic precision ensures surrounding tissue is spared.

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What Is Robotic Stereotactic Radiosurgery?

Stereotactic radiosurgery is a precise, painless, non-invasive radiation treatment that utilizes very accurately targeted, large “killing” doses of radiation. This non-invasive “operation” has proven to be an effective alternative to surgery or conventional radiation for treating many small tumors and a few other select medical disorders.

Multiple beams of high-energy radiation are delivered from multiple points outside of the body and converge precisely at the tumor or lesion inside the body. Each individual beam is not sufficient to cause harm, but the convergence of all the beams at the tumor results in the lesion receiving a very high dose of radiation while sparing nearby normal tissue.

Because CyberKnife radiosurgery is so precise, radiation beams can be sculpted to small, complex-shaped tumors near critical structures, such as hearing and vision nerves. This ability to accurately irradiate only the tumor and protect healthy tissue allows the CyberKnife to treat many lesions that may be considered inoperable or untreatable with other radiosurgery systems—giving many patients new hope.
Standard stereotactic techniques rely on a rigid metal frame fixed to a patient’s skull for head immobilization and target localization. However, such frame-based systems have numerous limitations, including:

  • Restricting treatment to the brain;
  • Limiting the possible angles at which radiation can  be delivered; and
  • Causing considerable discomfort for the patient.

In contrast to the standard frame-based radiosurgical instruments, the CyberKnife uses noninvasive image-guided localization and a robotic delivery system. This combination of technologies enables the CyberKnife to overcome the limitations of older frame-based radiosurgery such as the Gamma Knife and LINAC.

The CyberKnife belongs to a new class of radiotherapy techniques called image-guided radiotherapy (IGRT). The CyberKnife is unique in that it uses a compact linear accelerator (linac) mounted on an image-guided robotic arm to deliver multiple beams of high energy x-rays to a target. The ability of the CyberKnife to shape the profile of radiation to conform to the patient's individual anatomy allows for maximum sparing of surrounding normal tissues.

The CyberKnife accomplishes this by accurately cross-firing approximately 150 beams of radiation at the target from multiple directions. The CyberKnife technology represents an improvement upon the most advanced conventional radiation therapy techniques: Intensity Modulated Radiotherapy (IMRT). Similar to IMRT, the CyberKnife can produce a highly conformal dose distribution that “matches” the shape of the tumor and spares adjacent normal anatomy (such as the bladder and rectum for prostate cancer).

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What Is CyberKnife?

CyberKnife radiosurgery is non-invasive radiation treatment that can be a comfortable alternative to surgery in many cases. This system allows for precise delivery of higher, hyperfractionated radiation doses. The technology is proven and well established on the basis of previous radiation technology used for more than 30 years and over 90,000 patients have been treated worldwide. CyberKnife is the world’s exclusive provider of non-invasive robotic radiosurgery tumor treatment that can be used throughout the body.

The CyberKnife System is approved by the FDA to treat tumors and lesions anywhere in the body when radiation treatment is indicated. As an alternative to chemotherapy, CyberKnife can treat many types of cancer, including tumors, brain cancer, breast cancer, head and neck cancer, liver cancer, lung cancer, metastases, cancer of the pancreasprostate cancer, and spinal cancer.

The CyberKnife utilizes a combination of advanced technologies. To apply its exceptional radiosurgery performance, this system uses image-guided software that tracks subtle movements of the patient in real-time during the procedure and adjusts the treatment accordingly.

The CyberKnife can treat inoperable and hard to reach cancerous tumors. Because radiation is delivered from many angles, no single area of healthy tissue is adversely affected. Real-time monitoring of tumor position triggers near instantaneous adjustment of the direction of the high-dose radiation beams.

By avoiding traditional surgery, patients are spared the risks of infection, excess bleeding, complications from anesthesia, and uncomfortable recovery. There are few, if any, side effects and virtually immediate return to normal activities. As an alternative to chemotherapy, CyberKnife treatment causes fewer side effects.

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How Does CyberKnife Work?

The CyberKnife is a combination of two advanced technologies to apply its exceptional radiosurgery performance: This system uses image-guided software that tracks subtle movements of the patient in real-time during the procedure and adjusts the treatment accordingly.

The patient is lying down comfortably throughout the entire procedure — they may dress in everyday attire, with the only exception being the removal of any metals near the area of treatment. The CyberKnife system is gentle; our radiation therapy does not require the placement of frames fixed to the skull. As a substitute, the technology tracks movements while maintaining intense and precise radiation dosages. This technology is so accurate that no single area of healthy tissue is adversely affected. We treat tumors throughout the body, with precision that is comparable to no other cancer treatment system.     

    • Radiation Delivery – The radiation delivery system is mounted on a multi-jointed robotic arm. This articulation allows the arm to access areas of the body that are untreatable with conventional radiosurgery.
    • Image Guidance System – The lightweight radiation delivery system is guided by real-time imagery of a patient’s body. This advancement allows the CyberKnife System to track the tumor or lesion throughout treatment and correct for small patient movements in real time, thereby delivering precise radiation treatment with sub-millimeter accuracy.

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History of CyberKnife

In 1987, John R. Adler, MD, professor of neurosurgery and radiation oncology at Stanford University Medical Center, developed the CyberKnife System after completing a fellowship in Sweden with Lars Leksell, MD, who is the founder of radiosurgery. With the CyberKnife System, Adler’s vision was to develop a non-invasive robotic radiosurgery system with superior accuracy for treatment of tumors anywhere in the body. The revolutionary concept reached far beyond the practice of radiosurgery at the time, which restricted radiosurgery to the treatment of intracranial tumors.

The CyberKnife System is the world’s first and only radiosurgery system designed to treat tumors anywhere in the body with sub-millimeter accuracy. Using image guidance technology and computer controlled robotics, the CyberKnife System is designed to continually track, detect, and correct for tumor and patient movement throughout the treatment. Because of its extreme precision, the CyberKnife System does not require invasive head or body frames to stabilize patient movement, vastly increasing the system’s flexibility.

For more than 30 years, traditional radiosurgery systems, or systems that deliver precise, high dose radiation directly to a tumor, have been used primarily to destroy brain tumors. The CyberKnife System represents the next generation of radiosurgery systems, combining continual image-guidance technology with a compact linear accelerator that has the ability to move in three dimensions, according to the treatment plan. This combination, called intelligent robotics, extends the benefits of radiosurgery to the treatment of tumors anywhere in the body.

The CyberKnife procedure requires no anesthesia, can be performed on an outpatient basis, and allows for the treatment of patients who otherwise would not have been treated with radiation or who may not have been good candidates for surgery. In addition, the CyberKnife procedure avoids many of the potential risks and complications that are associated with other treatment options and is more cost effective than traditional surgery.

The World Health Organization (WHO) estimates that there are 24.6 million people living with cancer worldwide, with approximately 10.9 million new cases being diagnosed every year. To date, Accuray has brought the superior tumor treatment capabilities of the CyberKnife System to more than 200,000 patients around the world, including those with tumors previously considered inoperable or surgically complex.

Since the launch of the CyberKnife System, Accuray has undertaken an aggressive strategy to develop system enhancements that facilitate clinicians’ ability to treat tumors anywhere in the body with the highest levels of accuracy. Currently, Accuray has installed more than 150 CyberKnife Systems worldwide, and a large body of peer-reviewed papers supports its clinical practice. Accuray is committed not only to continuing its tradition of advancing the field of robotic radiosurgery, but also to providing its customers with the highest level of support in its  ongoing efforts to fight cancer.

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What Can We Treat?

Although most inoperable areas of the body are treated with CyberKnife technology safely, the most common treatments are for:

  • Acoustic Neuroma
  • Arteriovenous Malformations (AVM)
  • Astrocytoma
  • Bladder Cancer
  • Brain Cancer – primary, multiple, and metastases can be treated in one session
  • Cavernous Sinus Tumors
  • Colon Cancer
  • Glioma
  • Head and Neck Cancer
  • Kidney (Renal) Cancer
  • Liver (Hepatocellular) Cancer – primary and metastatic  
  • Lung Cancer – primary and metastatic  
  • Meningioma
  • Osteosarcoma
  • Pancreatic Cancer
  • Parasellar Meningioma
  • Pituitary Adenoma
  • Prostate Cancer
  • Rectal and Anal Tumors and Cancer
  • Skeletal Metastases
  • Solitary Lymph Node
  • Spinal Cord and Nerves – benign and malignant tumors
  • Spinal Cord Tumors – Cervical, Thoracic, Lumbar, and Sacral Spine – primary and metastatic
  • Spinal Cord Tumors – Intradural and Intramedullary
  • Trigeminal Neuralgia

(Breast cancer treatment is in the clinical review process.)

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Diseases Treated

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 prostate, lung, brain, spine, liver, pancreas, and kidney. 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 200,000 patients have been treated and more than 150 CyberKnife systems are installed worldwide.

Initially, radiosurgery was used to treat brain tumors; when technical improvements allowed for radiosurgery to be used anywhere in the body, the possible treatment sites were expanded to include cancer involving the spine. With more experience and further improvements in targeting tumors, the possible sites or types of cancers that may benefit have expanded dramatically. The most common sites are noted below:

Treatment Comparisons

The most common radiosurgery systems include Gamma Knife Systems, modified linear accelerators (Linac), and the CyberKnife. Although all of these systems are all capable of delivering the desired radiation dose to a specific area, there are major differences that could significantly impact the treatment and clinical outcome.


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Benefits of CyberKnife

Treatment with CyberKnife results in potentially fewer complications than invasive surgery and often allows patients to have a better quality of life during and after treatment. The CyberKnife System is a one-of-a-kind device for several reasons.

First, the CyberKnife System uses image guidance software to track and continually adjust treatment for any patient or tumor movement. This sets it far ahead of other similar treatments. It allows patients to breathe normally and relax comfortably during treatment.
Second, some forms of radiosurgery require rigid head-frames that are screwed into the patient’s skull to minimize any movement. The CyberKnife System 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.

Third, unlike some radiosurgery systems, which can only treat tumors in the head, the CyberKnife System has unlimited reach to treat a broad range of tumors throughout the body, including the prostate, lung, brain, spine, liver, pancreas, and kidney.

And, finally, the CyberKnife System’s treatment accuracy is unrivaled. Its ability to treat tumors with pinpoint accuracy is unmatched by other radiation therapy and radiosurgery systems. 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®

GammaKnife®

Other Linac Systems

Dedicated to radiosurgery

Yes

Yes

No

Does conventional radiotherapy and/or IMRT

No

No

Yes

Area treatable with radiosurgical precision

Entire Body

Brain and Skull

Varies (depending on system)

Rigid brain or body frame required

No

Yes

Yes

Lesion size limitation

No

Yes

No

Capable of preserving adjacent tissues by dividing treatments

Yes

No

Yes

Capable of tracking lesion in real time to follow motion caused by organ movement and breathing with radiosurgical precision

Yes

N/A

No

IMRT dosimetry method

Yes

No

Yes

IGRT set-up visualization

Yes

No

Yes

Capable of conformally and homogeneously treating a non-spherical target volume > 3.5cm

Yes

No

Yes

Capable of fractionated radiosurgery to better preserve critical adjacent tissue

Yes

No

Yes

Capable of real-time sub-millimeter translational and rotational beam adaptation to target volume motion

Yes

N/A

No

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Advantages of the CyberKnife System Include:

  • Extremely accurate radiation targeting means higher doses of radiation can be used, offering the patient a better chance for cure
  • Treats hard-to-reach tumors, many that may have been diagnosed as inoperable
  • Tumors receive radiation from many angles, minimizing damage to healthy tissue
  • Continually checks and compensates for any movement made during treatments, ensuring accuracy
  • Requires no metal head frame or skull pins
  • Eliminates risks related to surgery, including potential infection, complication from anesthesia, and post-operative bleeding
  • Requires no recovery time; most treatments are done on an outpatient basis
  • Patients undergo their treatment quickly, usually in just 1 to 5 sessions, and immediately resume normal daily activities.
  • Reduces pain
  • Requires no or minimal sedation

CyberKnife technology is designed with our patients in mind; it allows for subtle movements to keep the patient comfortable at all times. The system takes periodic X-rays to ensure the tumor is accurately targeted and the patient can calmly relax.

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Case Studies

CyberKnife Centers of Tampa Bay are committed to providing an improved quality of life and a non-surgical treatment option for those diagnosed with cancer. We strive to achieve this goal by supporting well designed clinical research in a variety of pathology specific applications.

Prostate
Low-Risk Organ-Confined Prostate Cancer
CyberKnife® Monotherapy for Low-Risk Prostate Cancer
Radiosurgery Proven Effective for Prostate Cancer
Facts About CyberKnife and Prostate Cancer

Lung
Non-Small Cell Lung Cancer - Left Upper Lung
Synchronous Bilateral Stage 1A Non-Small Cell Carcinoma
Treatment of Metastasized Colon Cancer in the Lung
Targeting Pulmonary and Spine Tumors
Applications in Pulmonology

Pancreas
Pancreatic Adenocarcinoma

Kidney
Primary Renal Cell Carcinoma

Spine
T6 Spinal Solitary Breast Metastasis
Recurrent Multiple Myeloma at Clivus & C1

Head and Neck
Head and Neck Tumors

Intracranial
Optic Apparatus Meningioma
Posterior Fossa Renal Cell Metastasis
Pediatric Anaplastic Astrocytoma
CyberKnife Brain Treatment
Acoustic Neuroma Case Study

Other
Recurrent Ovarian Carcinoma

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Referring a Patient

Physicians that are looking for the most effective treatment options available for their patients may want to consider the revolutionary stereotactic radiosurgery available at the CyberKnife Centers of Tampa Bay.

Please contact us if you have questions about how CyberKnife may benefit your patients or would like to set up a consultation, personalized tour of one of our centers or refer a patient to the CyberKnife Centers of Tampa Bay.

Director: Kevin Mayeski 
Phone: (813) 884-7400
Fax: (813) 884-7445
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Feel free to Contact Us if you'd like to learn more about CyberKnife Robotic Stereotactic Radiosurgery.

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Accurate Cancer Treatment

CyberKnife can treat benign tumors and many types of cancer, including, brain, head and neck, liver, lung, pancreatic, and prostate cancer, metastases, and spinal tumors.

Robotic Cancer Surgery

The CyberKnife System uses image-guided robotics to precisely destroy cancer tumors and other lesions. This precision spares normal, healthy tissue, while the higher dosage offers improved chances for cure from cancer. The CyberKnife can treat inoperable and hard to reach cancerous tumors.

We Accept Most Insurance Carriers

 

 

We work to obtain pre-authorization with all insurance companies.