Typical CyberKnife treatment

A Typical CyberKnife® Treatment

The following is an example of a typical treatment at the European CyberKnife Centre in Munich (ECZM), in this case for a brain tumour. The procedure and facilities may vary somewhat between centres and from patient to patient but this gives a good idea of what to expect.

For a soft tissue tumour an extra stage of placing several small metal markers (fiducials) near the tumour may be required, in order to track its position throughout the treatment. These must then be allowed to settle for a few days before CyberKnife treatment can be given.

This may require a return to Munich, however in most cases it will be sufficient to send MRI control scans and neurological follow up results on a CD. Alternatively follow-up may be made through your own doctor.

Step 1: Treatment Setup

Making a mask. A custom soft mask (for head/neck treatments) is formed and used to help minimize movements during the treatment and ensure your comfort. The process is simple and painless. ECZM uses additional software which enables it to treat spinal tumours without implanting fiducials.

Step 2: Treatment Planning

The CT data is downloaded to the CyberKnife® treatment-planning computer.

Physicians then use advanced software to customise the number, intensity and direction of radiation beams for the robot to send to the target.

You do not need to be present during this step.

Step 3: Treatment Delivery

Bring your favourite CD to help you relax! You will be monitored on five video cameras and can speak to the surgeons during treatment.

Wear comfortable clothing and no jewellery. Try to relax, knowing that this will be a painless procedure. Feel free to bring a list of questions to ask the CyberKnife® team. They are there to ensure your comfort and safety.

If you are undergoing single-session radiosurgery, your treatment is complete. You can usually leave and resume normal activity immediately.

Step 4: Follow Up

How cases are assessed

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For body (non-head) lesions a short outpatient procedure may be required to implant fiducials.

Imaging. A CT-scan is performed. Your surgeon and radiation oncologist use the scan to identify the exact size, shape and location of the tumour along with the surrounding vital structures to be avoided.

Arriving

Positioning

You will be asked to lie on the treatment table and be fitted with the custom mask or body mould made earlier during the set-up process. Generally, no sedation or anaesthesia is required because the treatment is painless.

Painless Treatment

During treatment you will need to lie still. You will be awake throughout the entire procedure which typically lasts 30-90 minutes depending on the complexity of your tumour.

The image guidance system periodically takes x-ray images and compares them to data from the CT scan to ensure that the radiation is targeted accurately to the tumour.

Completion

If your physician prescribes a “hypo-fractionated” or staged treatment, this will be spread over three or five consecutive days.

As with any radiosurgery or radiation therapy procedure, follow-up imaging and consultation is required to monitor your tumour’s progress, ideally on a six-monthly basis.

CyberKnife treatments < Typical CyberKnife treatment

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