Our centre is one of the leading facilities for innovative radiosurgery.
With CyberKnife and ZAP-X, we offer two advanced systems for high-precision radiosurgery with submillimetre accuracy. For selected indications, including vestibular schwannomas (acoustic neuromas), meningiomas and prostate cancer, these technologies enable effective, non-invasive and tissue-sparing treatment with a high level of patient comfort.
Learn more about the advantages of our treatment methods. Together, we will identify the most appropriate approach for your health and quality of life.
Modern radiosurgery is a highly precise, non-invasive treatment technique for selected benign and malignant tumours.
Advanced image-guided robotic systems such as CyberKnife and ZAP-X deliver high-energy photon beams to a precisely defined target. The beams converge within the target volume, allowing a highly conformal therapeutic dose to be delivered while minimising radiation exposure to surrounding healthy tissue. Depending on the indication and treatment plan, therapy may be completed in one or several sessions. For patients, this means high treatment precision, limited disruption to daily life and a short overall treatment duration. Rehabilitation is usually not required.
How does radiosurgery differ from conventional radiotherapy? What advantages can it offer, and for which conditions may it be suitable? Find out below.
Modern radiosurgery is an advanced form of high-precision photon radiotherapy. In selected cases, it provides a non-invasive, tissue-sparing alternative to surgery or conventionally fractionated radiotherapy. It can be used to treat selected benign tumours and malignant neoplasms with a highly conformal radiation dose.
Modern radiosurgery originated with the Swedish neurosurgeon Lars Leksell, who first used the Gamma Knife on 2 November 1967. Gamma Knife treatment was introduced in Munich in 1994. In 2005, Munich also became home to Germany's first robotic CyberKnife system for the high-precision treatment of tumours in multiple regions of the body.
In 2021, ERCM became one of the first centres worldwide to commission the ZAP-X robotic radiosurgery system. ZAP-X has been developed specifically for the high-precision treatment of intracranial and selected head-and-neck indications.
Open neurosurgery may require several hours, whereas a ZAP-X treatment session can, in selected cases, be completed in approximately 15 minutes.
Short treatment duration
Treatment is delivered in one or a small number of sessions, depending on the indication.
Painless
The treatment itself is painless and does not require a surgical incision.
No general anaesthesia
General anaesthesia is not usually required; patients remain awake and responsive.
No surgery required
The typical risks associated with an operative procedure are avoided.
Generally well tolerated
Side effects depend on target location and individual treatment plan, but severe adverse effects are uncommon.
No inpatient hospital stay
You can usually return home immediately after treatment and resume your normal daily routine.
High-precision radiosurgery for selected benign and malignant tumours in multiple regions of the body.
High-precision radiosurgery developed specifically for intracranial and selected head-and-neck indications.
Originally developed for the treatment of benign brain tumors and brain metastases, modern radiosurgery can now be used for a wide range of benign and malignant tumors throughout the body.
Radiosurgical treatment combines digital image guidance with high-precision robotic beam delivery. During treatment, the position of the target is repeatedly verified. If a positional change is detected, the system can adjust beam alignment accordingly.
For tumours affected by respiratory motion, an external three-dimensional camera records the breathing pattern while internal imaging verifies the target position. The robotic system synchronises beam delivery with target motion, effectively allowing it to 'breathe' with the patient.
During a treatment session, radiation is delivered from numerous beam directions. The individual beams converge within the planned target volume, where they produce the prescribed therapeutic dose while limiting exposure to adjacent healthy structures.
Radiation damages the DNA of tumour cells and impairs their ability to divide. Over time, the treated lesion may shrink, remain stable or show other imaging changes. The response and the time course vary according to tumour type, size and treatment objective.
Radiosurgical treatments using CyberKnife and ZAP-X are established, highly precise procedures for appropriately selected patients. The radiation dose is shaped to the planned target volume with submillimetre accuracy. This allows a highly conformal dose to be delivered while reducing exposure to surrounding healthy tissue as far as reasonably achievable.
At ERCM Munich, the technical accuracy and safety of the radiosurgical systems are verified daily by specialist medical physicists as part of rigorous quality assurance.
Unlike an invasive procedure, radiosurgery does not require a surgical incision. The body surface therefore remains intact during treatment. For some targets that may move between or during treatment, fiducial markers may be required to support precise image-guided localisation. Lung targets may move with respiration, while prostate position may change with bladder and rectal filling. Small gold fiducial markers can be placed in or near the target under local anaesthesia using a minimally invasive procedure. These implanted markers serve as reference points for precise target tracking during treatment.
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