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 and high-dose irradiation of a precisely defined target volume (tumor). It is usually carried out in a session of about 30 minutes. Radiosurgical treatment treats tumors in the head or body. The tumor cells are killed with this method.


How exactly is the tumor destroyed?

The radiation unit rotates around the patient – ​​typically 150 – 250 (out of 3,000 possible) radiation directions are used during treatment. The rays cross in the tumor in such a way that the tumor-destroying dose is reached there. Due to the highly concentrated radiation, the diseased cells are “biologically switched off” by damaging their genetic material (DNA), while the healthy surrounding tissue is protected as much as possible.


How does a tumor react after Cyberknife treatment?

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


How many times is a Cyberknife treatment repeatable?

As a rule, one application is sufficient to successfully eliminate the tumor. Depending on the type and location, the treatment can be divided into one to five sessions. If further tumors or metastases form in the body, the Cyberknife therapy can be used again. The Cyberknife technology works so precisely that the administered dose only reaches the tumor and largely spares the surrounding tissue, organs or nerves.


What tumors and lesions can be treated with Cyberknife technology?

The Cyberknife system was developed for the radiosurgical treatment of tumors and lesions anywhere in the body. The current therapy spectrum includes the following diseases in the head area: acoustic neuromas / vestibular schwannomas, meningiomas, angiomas – arteriovenous malformations (AVM), metastases, trigeminal neuralgia and choroidal melanomas.

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

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Is the treatment always “non-invasive”?

As a rule, the Cyberknife treatment is always non-invasive. However, prior to treating some respiratory (e.g., lungs) or mobile organs (e.g., prostate) to mark the tumor, gold markers may need to be inserted into the tumor tissue under local anesthesia. The gold markers are used to guide the treatment.


Are there side effects with Cyberknife therapy?

Cyberknife therapy is very gentle. Depending on the tumor, it usually has no or only minor, temporary side effects. Details are discussed according to the individual situation in a personal conversation with the patient before the treatment.


How Safe is Cyberknife Therapy?

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


What are the treatment benefits for the patient?

As a rule, 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
  • Quick return to normal everyday life
  • 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 devices combine 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 enables us to achieve even higher quality with a shorter treatment duration at the same time – to the benefit of the patients.


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 a treatment with the Cyberknife is medically checked individually for each case. If there is an indication for cyberknife therapy, the success rate is very high. The range of treatments is continuously adapted to scientific progress, so it is important to examine each individual patient situation.


Are the treatment costs covered by insurance?

There are direct agreements with the majority of health insurance companies to cover the costs of cyberknife treatment. These include, for example, the AOK Bayern, the Barmer GEK, the LKK, the Deutsche BKK, the KKH and most of the Bavarian BKKs. There are also corresponding agreements for privately insured patients.


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

In individual cases, it is carefully checked whether the strict indication criteria are met and whether cyberknife therapy is suitable. Otherwise, no special precautions need to be taken. Cyberknife treatment can be particularly suitable for patients in whom, for example, surgery is not possible or can be avoided due to other risk factors.


How much time do patients have to plan for a treatment, e.g. if they come from another city or abroad? How often should you come for follow-up care? Is it sufficient for follow-up care to send current MRI or CT findings by post?

Cyberknife therapy is an outpatient measure. Depending on the indication, three to five days should be scheduled for the entire duration of therapy. As after any medical intervention, outpatient check-ups are recommended. However, they can be carried out conveniently from your home town or country and the current findings sent to us (by post 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 purely for head treatments. The Cyberknife treatment, on the other hand, can be carried out anywhere in the body. A ZAP-X device does not require a bunker and shields itself. This means that relatives and the practitioner 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 often treated with ZAP-X technology.


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

Contractual agreements have already been made with AOK Bayern, BEK and most private insurance companies. We are in contractual negotiations with other health insurance companies. Please talk to us about your particular situation and we will support you as best we can in clarifying whether the costs will be covered.