What is the CyberKnife?

The CyberKnife is a frameless robotic radiosurgery system used for treating benign tumors, malignant tumors and other medical conditions. The CyberKnife Robotic Radiosurgery System is a method of delivering radiotherapy, with the intention of targeting treatment more accurately than standard radiotherapy.

The CyberKnife system is a non-invasive alternative to surgery for the treatment of both cancerous and non-cancerous tumors anywhere in the body. CyberKnife effectively treats prostate, lung, brain, spine (spinal cord), liver, pancreatic, kidney, neck and other soft tissue cancers. The treatment delivers beams of high dose radiation to tumors with extreme accuracy. It provides a pain-free, non-surgical option for patients who have inoperable, surgically inaccessible or surgically complex tumors such as Ewing's Sarcoma (cancerous tumor); metastasized tumors (such as brain cancer); recurring tumors or a second relapse of a tumor that was treated by other means such as conventional radiatherapy; or who may be looking for an alternative to surgery.

How does the CyberKnife work?

The two main elements of the CyberKnife are:

1. The radiation produced from a small linear particle accelerator, and
2. A robotic arm which allows the energy to be directed at any part of the body from any direction.

Unique features of the CyberKnife

1. It moves with the patient`s breathing so tumours can be targeted with greater accuracy, and damage to healthy tissue is reduced. The CyberKnife System uses image guidance software to track and continually adjust treatment for any patient or tumor movement. It allows patients to breathe normally and relax comfortably during treatment.
2. The CyberKnife System does not require such extreme procedures as rigid head-frames screwed into the patient`s skull to minimize movement and keep the patient in place. Instead, the CyberKnife relies on sophisticated tracking software, allowing for a much more comfortable and non-invasive treatment.
3. The CyberKnife System has unlimited reach to treat a broad range of tumors throughout the body, including the prostate, lung, brain, spine (neck, thoracic vertebrae), liver, pancreas, and kidney.
4. The CyberKnife System has the ability to treat tumors with pin-point accuracy. The CyberKnife System can essentially "paint" the tumor with radiation allowing it to precisely deliver treatment to the tumor alone, sparing surrounding healthy tissue.

Treatment process with the CyberKnife

The CyberKnife works by delivering multiple beams of high dose radiation from a wide variety of angles using a robotic arm. X-ray cameras monitor the patient`s breathing and re-position the radiotherapy beam in order to minimize damage to healthy tissue. This accuracy enables tumours to be treated that are in difficult or dangerous to treat positions, such as near the spinal cord.

There are 3 steps in the treatment process with the CyberKnife:

1. Scanning of the tumor
2. Development of treatment plan
3. Delivery of radiation

Scanning of the tumor

Before treatment can begin, the size, shape and location of the tumor is determined by imaging using a high-resolution CT scan. The image data is then digitally transferred to the CyberKnife System`s workstation, where the treatment planning begins.

Development of treatment plan

A qualified clinician then generates a treatment plan using the CyberKnife software to match the desired radiation dose to the identified tumor location while limiting radiation exposure to the surrounding healthy tissue.

Delivery of radiation

Once the treatment plan has been developed, the patient is ready to undergo the CyberKnife procedure. After the patient is positioned on the treatment table, the CyberKnife System`s computer-controlled robot slowly moves around the patient to the various locations from which it will deliver radiation to the tumor.

Each treatment session lasts between 30 and 90 minutes, depending on the type of tumor being treated. If treatment is being delivered in stages, patients will need to return for additional treatments over several days (typically no more than five), as determined by his doctor. Patients may experience some minimal side effects, but those often go away within the first week or two after treatment.

Availability of the CyberKnife treatment

The CyberKnife system is sold by the company Accuray. It is not widely available, although the number of centers offering the treatment around the world has grown in recent years to over 164, particularly centered in the USA, India, Turkey, the Far East, Singapore, Korea, Malaysia, Taiwan, Japan, Germany, Italy, Netherlands and other countries in Europe. To date, more than 60,000 patients have been treated using the CyberKnife System.

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