CyberKnife is Revolutionary Non-invasive Procedure

TECHNOLOGY SPOTLIGHT

A new and innovative radiosurgery system designed to treat tumors anywhere in the body with sub-millimeter accuracy.

cyberknife1-w An 80-year-old woman with cancer in both lungs had no chance of having surgery because of her poor health and medical condition. Typically, this diagnosis meant she would have to endure about six weeks of radiation to treat the tumors in her lungs, possibly worsening her condition and drastically changing her quality of life.

But the physicians at the Cancer Care Centers of Brevard (Florida) offered her an alternative – CyberKnife Robotic Radiosurgery, a revolutionary non-invasive procedure that delivers concentrated beams of radiation to targeted areas. “We recommended that she be treated with hypo-fractionated radiation treatment to both lung tumors simultaneously,” explained Dr. Ravi A. Shankar, a radiation oncologist with training in stereotactic radiotherapy and radiosurgery. He has been using the CyberKnife system since June.

The woman consented to the treatment, which was administered over a period of just three days. The results: “She is now three months post-treatment and recent radiological investigations show good response to the treatment,” Shankar said. “Plus, from a quality of life standpoint, the patient is able to get along with no changes to her previous lifestyle.”

Always at the forefront of innovative treatments and technologies when it comes to treating cancer, Cancer Care Centers of Brevard is accustomed to providing patients with top-notch, excellent care. But with the addition of the CyberKnife Robotic Radiosurgery System, the center now offers patients a targeted, painless alternative to surgery and opens up a treatment option for those whose tumors and lesions were diagnosed as “inoperable” or otherwise untreatable.

The system treats tumors and lesions on the skull, head, neck, lungs, pancreas, prostate, spine, kidney and liver as well as melanomas. “I think this is a great technology,” said Radiation Oncologist Todd V. Panarese, M.D. “With the CyberKnife, we can certainly treat more tumors in areas that were either not possible before or that we went into with great trepidation because of their location,” he said.

Dr. Silas Charles

Silas J. Charles, MD, founder of the Cancer Care Centers of Brevard was the mastermind in bringing the CyberKnife to Brevard and Indian River Counties, Florida. The CyberKnife radiosurgery system was created by industry leader Accuray, Inc. and is approved by the FDA.

Physicians on staff are highly trained in CyberKnife operations and the center treats patients in a state-of-the-art CyberKnife suite.
During the treatment setup, patients undergo a pre-treatment CT scan and/or MRI to gather information on the size, shape and location of the tumor or lesion. Physicians then work with the surgeon to determine the correct dosage of radiation and where on the body the radiosurgery should be performed.
The information is uploaded into the CyberKnife’s computer software, which then locates the position of the tumor within the body through the use of image guidance cameras similar to those used for cruise missile guidance.
The CyberKnife then uses a miniature linear accelerator mounted on a robotic arm to deliver concentrated beams of radiation to the targeted tumor. The dose of radiation is high enough to control or kill the tumor cells while minimizing radiation exposure to surrounding healthy tissue.
The system is highly accurate, down to a sub-millimeter, which is perfect for achieving surgical-like outcomes for lesions of the brain and spine. Because it is non-invasive – with no pain, blood loss or sedation during treatment – it has significantly fewer complications than traditional open surgery.

Plus, the CyberKnife system considerably shortens the duration of radiation treatment, Shankar said. “Even though we have no long-term data, we see that the side effects from this form of treatment are considerably of shorter duration. There is less recovery time so that patients tend to get back to their normal lifestyles quicker,” he said. “They are also happy that the radiation treatment is not such a prolonged course as it normally is with the standard forms of radiation treatment,” he added.

CYBERKNIFE’S computer software locates the position of the tumor within the body through the use of image guidance cameras similar to those used for cruise missile guidance.

Two added features to the CyberKnife system are its Synchrony Software and Xsight Lung Tracking System. Synchrony uses a complex system of cameras, motion-tracking software, fiber-optic sensing technology and infrared emitters to accurately deliver radiosurgery to soft-tissue tumors, such as lung, pancreas, kidney, and liver lesions. The Xsight Lung Tracking System uses sophisticated image processing and registration techniques to directly lock onto and track tumors throughout the treatment.

Panarese said the CyberKnife Robotic Radiosurgery System gives the Cancer Care Centers of Brevard a “new tool in our arsenal to treat cancer.” Patients’ responses to the radiosurgery system have been overwhelmingly positive, he said. “I’m finding that patients are now requesting more information on the CyberKnife in anticipation of receiving treatment with it,” he said.

Shankar added that patients are informed beforehand that the CyberKnife treatment is a relatively new technique with no long-term data. “However, the short-term results from various centers show that it is equivalent to the standard forms of radiation treatment,” he said.

“With more and more people undergoing this form of treatment and the data continuing to be good, this may become the standard form of treatment for many cancers.”