Extracranial Stereotactic Radiotherapy: Preliminary Results with the CyberKnife®

Abstract

In the field of radiation oncology, equipment for fractionated radiotherapy and single-dose radiosurgery has become increasingly accurate, together with the introduction of robotized treatments. A robot is a device that can be programmed to carry out accurate, repeated and ad-justed tasks in a given environment. Treatment of extracranial lesions involves taking into account organ mobility (tumor and healthy tissue) whilst retaining the ability to stereotactically locate the target. New imaging techniques (single-photon emission computed tomography (SPECT), magnetic resonance imaging (MRI), positron emission tomography (PET)) provide further relevant information to slice images (computed tomography (CT) scans, MRI) for target definition. Hypo-fractionated treatments can only be used for curative treatment if the target is accurately defined and tracked during treatment. The CyberKnife^® is a non-invasive system of radiosurgery and fractionated stereotactic radiotherapy. For intracranial lesions treated by single-dose radiosurgery, it has been used to treat meningioma, acoustic neuromas, pituitary adenoma, metastases, arteriovenous malformations and refractory pain (trigeminal neuralgia). More than 10,000 patients have been treated worldwide. Currently, the most significant developments are in the field of extracranial stereotactic radiotherapy (lung, liver, reirradiation, prostate, etc.). Clinical results obtained in the Cyberknife Nord-Ouest program after 1 year of experience are presented.

Successful control of recurrent angiosarcoma in the external auditory canal with CyberKnife radiosurgery and bisphosphonate risedronate sodium

“…8,9,16 CyberKnife delivers extracranial stereotactic radiotherapy with millimetric precision, leading to disease control and toxicity profiles that are equal to or better than those of other available therapies. 10 Although areas irradiated using conventional radiotherapy show local recurrence, in the present case, AS could be controlled for 1 year using CyberKnife, even the remote metastatic lesions. Our present case suggested that CyberKnife is one of the optimal tools for the local control of AS.…”

Retrospective Analysis Of Patients And Treatment Characteristics: Istanbul Cyberknife Coalition Data

“…Reviews mainly agree on the advantages of the system, such as the frameless usage, accuracy in less than 1mm, image fusion capability with multiple modalities, real time tumor tracking, and treatment possibility with linear accelerator [3,[6][7]. The majority of clinical trials using CK are mainly focused on intracranial lesions.…”

Avancées en radiothérapie externe des cancers du sein

“…Le système orthogonal permet de suivre la cible en temps réel grâce à des marqueurs implantés de type fiduciaire ou par corrélation osseuse. La précision inframillimétrique de l'irradiation est obtenue grâce aux collimateurs, au positionnement tridimensionnel ainsi qu'au repositionnement en temps réel [13,14]. Les indications dans les métastases osseuses du cancer du sein sont nombreuses, notamment au niveau du rachis [9].…”