Thanks to its innovative design and the ground-breaking technology it applies, it is in many cases the only solution, while it can also be used as a complementary method, following surgery, conventional radiotherapy or chemotherapy.
5 main part cooperation to perform medical Stereotactic Radiosurgery
Cyberknife consists of 5 main parts, used in cooperation to perform medical Stereotactic Radiosurgery, these are:
- A special compact 6 MV linear accelerator with a dose rate of 600 MU/min (Monitor Units per minute).
- A robotic arm capable of movement in six axes (6 degrees of freedom), to allow directing the beam anywhere in space. This arm is guided and controlled by a powerful computer, which does not allow deviation errors greater than 0.2 mm.
- An (image-guided) Digital Radiography System, which guides the robot and hence the beam to monitor patient movement and thus the target (tumour or other pathological focus) to automatically correct the corresponding parameters
- A specially designed treatment table A treatment planning system with modern and powerful computers and sophisticated software with many great features (forward and inverse treatment plan, single, multi, iso & non-isocentric treatment)
- The special "Synchrony" system, consisting of devices and software used for treatments in organs that move during pulmonary function (lungs, liver, pancreas, etc.)
What are the advantages of CyberKnife?
Compared with the other methods of stereotactic radiosurgery, it is the only one whose application extends to all parts of the body and is not limited to the brain.
It is the only one that does not require the application of a painful head frame for brain treatments.
- Precise targeting (within 1 mm) of the lesion, irrespective of the body part where the treatment is to be applied.
- It can deliver radiation to targets of any shape, as it is not limited to isocentric treatment, but directs beams from different sides to the target, in accordance with the treatment plan that has been prepared and applied by the robot.
- It allows control of the target and focusing the therapeutic beam in real time throughout the duration of treatment, as it uses an advanced imaging guidance system (Image Guided Stereotactic Radiosurgery).
- It corrects the direction of the therapeutic beam during treatment, in line with the patient's slight movements (synchrony system).
- CyberKnife's flexibility allows treatment planning via a multitude of options, including forward or inverse plans.
Conditions treated with CyberKnife
In the liver, the pancreas & the lungs
In the lungs:
• Stage I or II non-small cell lung cancer
• Local relapse of NSCLC, after radiotherapy
• Persistent solitary SCLC focus after chemo & radiotherapy
• Solitary pulmonary metastasis
In the liver:
• Hepatocellular cancer
• Hepatic metastases
In the pancreas:
/ for local disease, as monotherapy or in combination
/ for disseminated disease - combined with chemo or radiotherapy)
CyberKnife can be used for the treatment of the above in the following ways:
Either as a first-line option
- Or as an alternative to surgery
- Or as an adjunct to surgery
- Or as an adjunct to radiotherapy
- Or in combination with chemotherapy
- Or in combination with chemo and radiotherapy
The CyberKnife detects the target, using a digital imaging system in real time, and monitors tumour movements, due either to patient movement during the examination or to the movement of the tumour due to the respiratory function. The synchrony technique is implemented to eliminate all these slight movements.
The decision as to whether and how the patient will be treated is taken after evaluation of his/her medical file by the CyberKnife scientific team (a radiotherapist-oncologist, a doctor specialising in the treated organ and a radiation physicist).
In the prostate
The application of CyberKnife robotic stereotactic radiosurgery in the prostate offers many advantages compared to other alternatives for the treatment of adenocarcinomas.
It is not invasive (unlike radical prostatectomy)
no anaesthesia is used, no recovery time is required, as there is no damage to normal tissues.
In low-risk patients, it is the most modern and safe non-invasive method.
In the brain and spinal column
Image-Guided Stereotactic Radiosurgery is very often the only solution,
as it can accurately and selectively reach less accessible target lesions in the brain and spinal cord with a fine X-ray beam, without damaging adjacent vital areas.
What types of lesions does it address?
- Vascular malformations of the brain
Arteriovenous malformations (AVMs)
- Incipient brain, skull base and spine tumours, including:
Meningiomas, schwannomas, including acoustic neuromas and certain cases of NF2, chordomas, pituitary adenomas, craniopharyngiomas, haemangeiopharyngiomas.
- Primary, recurrent or residual tumours of the spinal cord and spinal column:
Sarcomas, malignant chordomas etc., arteriovenous malformations (AVMs) of the brain and spinal cord.
- Metastases in the brain and spinal cord by neoplasms such as: lung, breast, prostate, thyroid tumours, melanoma.
Dysfunctions: trigeminal neuralgia, Parkinson's disease, epilepsy.
Its advantages over open surgery:
- It prevents hospital stays and hospitalisation after the end of treatment, so the patients can return to their daily activities.
- It entails no procedures for surgery, general anaesthesia, postoperative pain, recovery time, possible nosocomial infections.
- It avoids potential damage to adjacent sensitive nerve formations from unavoidable surgical handling and accesses.