CyberKnife is a tool, not a treatment.
The principal treatments are as follows.
AVM (arterio-venous malformations)
Jugular foramen tumours
MPNST (malignant peripheral nerve sheath tumours)
Lung metastases (single)
Lung cancer (Stage I)
Renal cell cancer (Stage I)
Body lesions are treated with the Synchrony® (breath triggered robot movement) system.
Note: these treatments are more complex than brain and spine treatments and may require coordination with other medical specialists.
CyberKnife after radiotherapy?
The high precision of CyberKnife treatments means that they can sometimes be performed after conventional therapy, if the tumour could not be controlled, even where the maximum radiotherapy has already been given.
CyberKnife can be used to treat tumours in the brain, eye, spine, liver, lung, prostate, pancreas and other areas.
This means that you should not simply assume that all CyberKnife centres offer the same treatments to the same standards and just look for the nearest one.
The various organs of the body may be more or less sensitive to radiation than their surrounding tissue, so special protocols have been developed for different types and locations of tumour.
This work continues at top, pioneering CyberKnife centres, so the range of CyberKnife treatments available is increasing over time.
CyberKnife is best suited to small, well-defined early-stage tumours. As tumours grow the margins become less well defined, so the benefit of precise targeting is reduced.
Alternatively where tumours are both large and in inoperable locations, they may be reduced by surgery or chemotherapy and then treated by CyberKnife.
In these circumstances proton therapy or ion beam therapy may be the preferred option.
Treatments do not take more than a few days, so it is more important to find the right centre for the treatment that you require.
Not just for cancer
High precision also means that CyberKnife can be used for neurosurgery, e.g. trigeminal neuralgia, AVM or acoustic neuroma.
Also the number of beams that have to be used increases and with that the total delivered dose, so CyberKnife cannot be used for large tumours.
Ion beam therapy may also be an option in such cases, as tissues on the path to and beyond the tumour receive much less radiation than with X-ray beams.
Brain or spine treatments
Brain metastasis before and three months after treatment.
Uveal melanoma is cancer of the eye which involves the iris, ciliary body, choroid or a combination of these. A variety of treatments is available but in severe cases complete removal of the eye can be required.
CyberKnife radiosurgery at a few specialised centres avoids the need for this drastic step.
It involves a single-session treatment where retrobulbar anesthesia, CT scanning, planning and treatment by CyberKnife radiosurgery are all performed within a time frame of about two hours.
Special expertise required
Treatment of uveal melanoma by CyberKnife requires very delicate handling and experience is very important.
VISION 2020 UK is an umbrella organisation which facilitates greater collaboration and co-operation between organisations within the UK, which focus on vision impairment and operate on a national, regional or international basis. Vision 2020 is a supporting member of the Vision 2020 Global Initiative.
Few CyberKnife centres are able to offer this treatment, but MHL works with the centre in Munich where eye cancer treatments by CyberKnife were developed and with other experienced centres where this is also now available.
Body (soft tissue) treatments
The principal treatments are as follows.
* Cardiac sarcoma is a recent area of treatment but we are able to refer patients to the centre in Germany which developed this.
Small metal markers (fiducials) must be placed a few days before treatment and allowed to settle, to allow CyberKnife to track the tumour during breathing
We also work with the CyberKnife centre that is developing a new ultrasound guidance system to replace the need for metal fiducials.
CyberHeart development work for cardiac arrhythmia is under way but treatments are not yet available.