Questions & answers about treatment in the ERCM

Do you have questions about treatment in the ERCM? You’ll find the answers here.


What is radiosurgery?

Radiosurgery is the high-precision, high-dose irradiation of a precisely defined target volume (tumor). It is usually performed in a session that lasts about 30 minutes. Radiosurgery is used to treat tumors in the head or body. It kills the tumor cells.


How exactly is the tumor destroyed?

The radiation unit rotates around the patient – typically 150-250 (out of 3,000 possible) directions of radiation are used during treatment. The beams cross in the tumour so that the tumor-destroying dose is reached there. The highly concentrated radiation “biologically switches off” the diseased cells by damaging their genetic material (DNA), while sparing as much healthy surrounding tissue as possible.


How does a tumor react after Cyberknife treatment?

In Cyberknife treatment (radiosurgery), a tumor is “bombarded” with high-energy light particles (photons) from many different directions. This effective dose is delivered centrally to the tumor. It essentially reaches the diseased cells and destroys their genetic structure – the tumor dies. The tumor regresses over a period of weeks to months. In rare cases, the tumor may swell after treatment. This is usually temporary and easily controlled.


How many times is a Cyberknife treatment repeatable?

One application is usually sufficient to successfully eliminate the tumor. Depending on the type and location of the tumor, treatment may be divided into one to five sessions. If additional tumors or metastases form in the body, Cyberknife therapy can be used again. Cyberknife technology is so precise that the dose is delivered only to the tumor, sparing surrounding tissue, organs or nerves.


What tumors and lesions can be treated with Cyberknife technology?

The Cyberknife System is designed for the radiosurgical treatment of tumors and lesions throughout the body. The current treatment spectrum includes the following diseases of the head: acoustic neuromas/vestibular schwannomas, meningiomas, angiomas – arteriovenous malformations (AVM), metastases, trigeminal neuralgia and uveal melanomas.

Cyberknife is also used in the body and on organs: prostate (prostate cancer), spinal column/spinal cord (metastases, spinal neurinomas, spinal meningiomas), lung (stage I/II bronchial carcinoma, metastases), liver (primary hepatocellular carcinoma, metastases), kidney (renal cell carcinoma, urothelial carcinoma).

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Is the treatment always “non-invasive”?

In general, Cyberknife treatment is always non-invasive. However, before treating some respiratory (e.g., lung) or mobile organs (e.g., prostate) to mark the tumor, it may be necessary to insert gold markers into the tumor tissue under local anesthesia. The gold markers are used to guide treatment.


Are there side effects with Cyberknife therapy?

Cyberknife therapy is very gentle. Depending on the tumor, there are usually no side effects or only minor, temporary side effects. Details will be discussed with the patient prior to treatment.


How Safe is Cyberknife Therapy?

The Cyberknife treatment always hits the tumor exactly – healthy tissue is optimally protected. A precision robot delivers the high radiosurgical dose to the tumor from many directions with pinpoint accuracy. Movements of the target volume (tumor) are detected by an image localization system and compensated by the robot. For tumors that can breathe, a 3D camera also records external respiration to dynamically guide the beam to the target – the robot “breathes” with the tumor.


What are the treatment benefits for the patient?

In general, Cyberknife therapy has many advantages for the patient:

  • No surgery
  • No pain
  • No anesthesia
  • No hospital stay
  • No rehabilitation
  • No risk of bleeding or infection
  • Rapid return to normal daily activities
  • Short treatment time compared to conventional radiotherapy
  • No head frame


What are the advantages of the Cyberknife technique in tumor treatment?

The latest generation of Cyberknife systems combines maximum precision with flexibility. The photon beam can be shaped using different aperture systems (round, variable iris and multi-leaf collimators). Depending on the size, location and position of the tumor, we select the appropriate system. This allows us to achieve even higher quality and shorter treatment times for the benefit of the patient.


How often does a cyberknife treatment fail?

The indications for Cyberknife therapy are very strict. The tumor must not exceed a certain size and must be localized. The suitability of Cyberknife treatment is evaluated on a case-by-case basis. If there is an indication for Cyberknife therapy, the success rate is very high. The range of treatments is constantly being adapted to scientific progress, so it is important to evaluate each patient’s individual situation.


Are the treatment costs covered by insurance?

There are direct agreements with most health insurance companies to cover the cost of Cyberknife treatment. These include AOK Bayern, Barmer GEK, LKK, Deutsche BKK, KKH and most Bavarian BKKs. Similar agreements are also in place for privately insured patients.


Do patients have to meet certain requirements in order to be treated with the Cyberknife method?

Each case is carefully evaluated to determine if the strict indication criteria are met and if Cyberknife treatment is appropriate. Otherwise, no special precautions need to be taken. Cyberknife treatment may be particularly suitable for patients who cannot undergo surgery or who have other risk factors that preclude surgery.


How much time do patients have to plan for treatment, e.g. if they are coming from out of town or abroad? How often should they return for follow-up? Is sending current MRI or CT results by mail sufficient for follow-up?

Cyberknife therapy is an outpatient procedure. Depending on the indication, three to five days should be scheduled for the entire duration of therapy. As with any medical procedure, outpatient check-ups are recommended. However, they can be performed conveniently from your home town or country and the results can be sent to us (by mail or e-mail).


What new trends can be observed in cyberknife treatment (related to new indications, new technical developments)?

Cyberknife technology for treating tumors is constantly being further developed. This technical progress guarantees patients the highest standard of medical and technical care. Only the most modern Cyberknife® devices are used in the ERCM. In this way, significantly shorter treatment times can be achieved with the same level of safety and tumor control. Overall, cyberknife therapy is becoming increasingly established. She continues to gain meaningful long-term results. Cyberknife has been in use here in Munich since 2005. We ensure a successful therapy of benign and malignant tumors with the most modern technology as well as very good radiosurgical experience and scientific knowledge.

Questions & answers about ZAP-X therapy


What is the difference between the Cyberknife and a ZAP-X treatment?

The ZAP-X technology is designed for head-only treatments. Cyberknife treatment, on the other hand, can be performed anywhere in the body. A ZAP-X device does not require a bunker and shields itself. This means that relatives and the physician can be in the treatment room during the treatment.


What are typical indications for ZAP-X therapy?

Brain metastases, acoustic neuromas, meningiomas, and arteriovenous malformations are commonly treated with ZAP-X technology.


Does my health insurance pay for a ZAP-X treatment?

Contracts have already been signed with AOK Bayern, BEK and most private insurers. We are currently negotiating with other health insurance companies. Please talk to us about your specific situation and we will do our best to help you clarify whether the costs will be covered.