GENTLE TREATMENT

Generally, tumors in all parts of the body with a positive indication for radiosurgical therapy can be treated with the Cyberknife. Tumors, for example, must not be too large and must have clear boundaries. In these cases, Cyberknife technology can be used

as an alternative to surgery or radiation therapy lasting several weeks. Using the latest in medical high technology allows it to treat even very irregularly shaped tumors in the area of critical brain regions such as the visual or auditive nerve, without damage to these sensitive brain areas.

ADVANTAGES OF TREATMENT

If the criteria for Cyberknife therapy are met, the treatment offers numerous benefits for the patient.

non-invasive

Cyberknife offers a promising treatment option without the drawbacks of a classic surgery.

pain-free

Cyberknife therapy does not cause pain.

no anaesthesia

During Treatment performed during the treatment.

Short treatment

Usually only one treatment is needed. This takes about 30 minutes.

Organ and functional preservation

Cyberknife can fight tumours such as acoustic neuromas, meningeomas or brain metastases in the sub-millimeter range. This protects healthy tissue.

no head-frame

A frame fixation on the skull is not required with Cyberknife.

No restriction on everyday life

Cyberknife can in many cases replace conventional radiation therapy that lasts several weeks.

Outpatient procedure

Therapy with Cyberknife does not require a prolonged hospital stay.

No rehabilitation

Rehab is not necessary after Cyberknife treatment.

GLOSSARY

Uveal melanoma
Acoustic neuroma
Meningioma
Angiomas – arteriovenous malformations
Brain metastases
Trigeminal neuralgia

Spinal metastases
Spinal neurinoma
Spinal meningioma

Liver metastases

Renal cell carcinoma

Prostate cancer (Gleason 6 and 7, PSA < 15 ng/ml)

Prostate cancer (metastases)

Lung cancer and lung metastases

Singular lymph node metastasis

MODERN TUMOR TREATMENT

In the interview, neuro and radiosurgeon Prof. Dr. med. Alexander Muacevic explains, among other things, when the gentle therapy can be used, for whom the outpatient method is suitable, and how the well-established Munich Center deals with the cost of effective treatment.

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CYBERKNIFE – TREATMENT PROCESS

The treatment process consists of several components: a first interview, the imaging, the treatment planning, the actual precision radiation, and routine follow-up examination.

For lesions located in the brain, an individual head rest is moulded. This keeps the head still during the treatment as much as possible. For spinal tumors and body lesions no specific positioning devices are needed.

For each treatment computed tomographic (CT) and MR examinations are required. For brain, spine and liver lesions an MRI not older than 4 weeks is mandatory. For lung lesions a CT scan is sufficient. Depending on the individual constellation of the disease, the additional planningCT examination in our center can take place immediately before or already one day prior to the actual treatment.

Already existing MR images may be transferred via CD for the treatment planning procedure.

The CT and MRI data are logged onto a computer so that the attending physicians and specialised medical physicists can plan and simulate the number, intensity and direction of the beams which the robot will deliver to the target. Depending on the location and size of the lesion, this calculation may take up to 24 hours. During this planning phase the patient does not need to be present.

Treatment is performed in our very modern practice rooms at Max Lebsche Platz 31 in an outpatient setting. On the day of treatment no special measures have to be taken. Have breakfast as usual and take any medicine, if applicable. An accompanying person for your personal support is welcome. If desired, your favourite music CD can be played during the treatment.

a) Positioning

At the beginning of the treatment the patient is requested to lay down on the treatment table while the head rest moulded previously or the body guide is placed. Anaesthesia is not necessary since the treatment is entirely pain free.

b) Precision radiation

During the treatment the patient should lie as still as possible, smaller movements however are tolerated. With video cameras the patient is observed by the treating physicians. Via microphone the patient can any time get into contact with the attending doctor. Altogether a time frame of about 45 – 90 minutes for the actual treatment is calculated.

Normally only one treatment session is required. In rare cases, it may be necessary to divide the radiation dose into several sessions. The patient is usually treated on consecutive days. After the treatment the patient can leave the Cyberknife Center and resume usual daily activities.

As after each medical intervention, it is recommended to come for regular outpatient follow-up examinations in order to determine the actual health status.

HOW CYBERKNIFE WORKS

The Cyberknife system is a novel, revolutionary achievement in the medical field – it combines two modern advancements in medical high technology.

The first innovation consists of a particularly lightweight and compact radiation device mounted on a robotic arm. he precision robot – which is also used in the automobile industry – can move freely in 6 plains.

Thus all body parts can be accessed without problems for an optimal treatment. The system is clearly more flexible in handling and hence more effective than conventional systems.

The second innovation consists of a computer assisted image guidance targeting system. With this technology the Cyberknife can target the tumor throughout the treatment and smaller patient movements can be compensated for. Thus it is no longer necessary to fix the head of the patient in a frame, to immobilize the body or to administer anaesthesia, as is required for conventional systems.

The third technical innovation relates to the capability of the treatment beam to follow moving targets. This is particularly important for tumors in the lung, liver and renal gland as they move considerably with breathing. In conventional radiation therapy patients are therefore put into fixating devices and a larger margin around the lesion is applied to be certain to hit the target during treatment. Sometimes the patient is even put into breath arrest during beam on times.

Cyberknife does not need these rather cumbersome techniques: External breathing is monitored with a infrared camera and correlated with the internal tumor motion. The robot is following then the tumor during treatment and one can say Cyberknife is breathing with the patient.

Thanks to this unique technology, easily identifiable tumours in the brain, spinal cord, spinal column, lung, liver and kidney or prostate gland can be treated precisely and effectively.

In contrast to conventional radiotherapy, radiosurgery as a special form of radiotherapy is usually performed once or in individual cases in up to five sessions.