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How the CyberKnife Works
As the patient rests comfortably on a table without restraints or a metal frame bolted to the skull, CyberKnife delivers multiple radiation beams from many points outside the body to the targeted tumor. On its own, each beam is relatively weak, but when they converge on the identified mass, they deliver high-energy, pinpointed radiation with astounding power.

The groundbreaking CyberKnife system couples two advanced technologies:
 
• A light-weight radiation source (linear accelerator) mounted on an ultra-flexible, multi-jointed robotic arm moves constantly, providing unprecedented access to areas of the body that cannot be reached by conventional radiosurgery systems.
• An image guidance system uses several computerized X-ray cameras to verify the tumor's location, track its position and remain on target even as the patient breathes during treatment. The images allow the robotic arm to compensate for tumor movement and reposition the linear accelerator, which then changes the angle and direction of the radiation beams and delivers them to the targeted site quickly and accurately -- anywhere in the body.

• Treatment for tumors inoperable by conventional surgery or other stereotactic radiosurgery
• Additional treatment option for tumors that have received maximum allowed radiation
• Painless, bloodless and non-invasive
• High-dose radiation delivered accurately
• Ability to treat multiple tumors at different locations during a single session
• Healthy tissue unharmed
• No need for invasive, uncomfortable head frame or skull pins
• Full-body treatment capability

Treatable Conditions
CyberKnife is cleared by the FDA for treatment of tumors and lesions anywhere in the body when radiation therapy is indicated. However, patients should consult their physicians to determine if this treatment approach is right for them. Conditions that can be treated with CyberKnife include:

• Primary & Metastatic Brain Tumors
• Spine Cancer
• Spinal Cord Tumors
• Soft Tissue Tumors
  • Lung
  • Kidney
  • Liver
  • Pancreas
  • Prostate
• Acoustic Neuromas
• Meningiomas & Skull-base Tumors
• Pituitary Tumors
• Recurrent & Residual Tumors
• Arteriovenous Malformations (AVMs)
• Functional Disorders, such as Trigeminal Neuralgia

Preliminary Setup

• Patients undergoing CyberKnife treatment for a spinal or body lesion may require the implantation of several small markers (fiducials) near the tumor to enable the system to track its position throughout the procedure. Lesions in the head do not require this process.
• A customized, soft facemask (for head/neck treatments) or body mold is formed to help minimize movement. The process is painless and simple.
• A CT Scan is performed to identify the size, shape and location of the tumor, as well as surrounding tissue to be avoided. In some situations an MRI may also be performed.

Treatment Planning

With the CT data downloaded to the CyberKnife treatment-planning computer, physicians use advanced software to customize the treatment plan. They determine the number, intensity and direction of the radiation beams required. Patients do not need to be present for this.


Painless Treatment Delivery

• This is a painless procedure, and patients are urged to relax. Comfortable clothing should be worn without any jewelry. Patients are encouraged to bring a list of questions to ask the CyberKnife team, which is there to ensure comfort and safety.
• While lying on the treatment table, the patient is fitted with the custom mask or body mold created during the earlier setup process.
• Patients are fully awake through the entire procedure, which lasts approximately 30-90 minutes depending on the complexity of the tumor.
• The Cyberknife robot will move slowly around the patient and deliver the radiation. Periodically the image guidance system will take X-rays to ensure the treatment is being delivered accurately.

Completion

For a single treatment, the process is complete after one session, and the patient can usually leave the hospital, resuming normal activity immediately. If the physician prescribes staged or "hypofractionated" treatment, the patient will return for additional daily treatments -- typically no more than 2-5.


Follow Up

As with any radiosurgery or radiation therapy, follow-up imaging and physician consultation are required to monitor progress.