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What is robotic stereotactic radiosurgery, e.g. Cyberknife?

Stereotactic radiosurgery is a medical procedure that utilizes very accurately targeted, large “killing” doses of radiation. This noninvasive “operation” has proven to be an effective alternative to surgery or conventional radiation for treating many small tumors and a few other select medical disorders.  see video and read reviews here and here.

There is evidence that giving the radiation in large single doses and fewer treatments or fractions (called hypofractionation) may be more effective than conventional treatment (multiple fractions of small doses, called fractionated radiation) The safe and proper dose is much different. See the tables for brain here and tables on doses for single fraction or three fractions or five fractions

more videos here, here, here, here, here, here, here, here, here, here

Conditions treated with Cyberknife:

 

Best Web Sites:

 

 

 
Standard stereotactic techniques rely on a rigid metal frame fixed to a patient’s skull for head immobilization and target localization. However, such frame-based systems have numerous limitations, including:

1) restricting treatment to the brain,
2) limiting the possible angles which radiation could be delivered,
3) causing considerable discomfort for the patient.

In contrast to the standard frame-based radiosurgical instruments, the CyberKnife uses noninvasive image-guided localization, and a robotic delivery system. This combination of technologies enables the CyberKnife to overcome the limitations of older frame-based radiosurgery such as the Gamma Knife and LINAC. (see patient manual page 1 and page 2.

The CyberKnife belongs to a new class of radiotherapy techniques called IGRT (image-guided radiotherapy. Go here for an update on new radiation techniques.)  The CyberKnife is unique in that it uses a compact linear accelerator (LINAC) mounted on an image-guided robotic arm to deliver multiple beams of high energy x-rays to a target. The ability of the CyberKnife to shape the profile of radiation to conform to the patient's individual anatomy allows for maximum sparing of surrounding normal tissues. The CyberKnife accomplishes this by accurately cross-firing approximately 150 beams of radiation at the target from multiple directions. The CyberKnife technology represents an improvement upon the most advanced conventional radiation therapy techniques, Intensity Modulated Radiotherapy (IMRT). Similar to IMRT, the CyberKnife can produce a highly conformal dose distribution which 'matches' the shape of the prostate and spares adjacent normal anatomy (bladder and rectum).
  Other Cyberknife centers with good information:
HISTORY

The CyberKnife System was first developed in 1987 by a team at Stanford lead by John R. Adler, M.D., a professor of neurosurgery and radiation oncology at Stanford University Medical Center. Dr. Adler had the vision to develop a non-invasive robotic radiosurgery system with superior accuracy for treatment of tumors anywhere in the body. The revolutionary concept reached far beyond the practice of radiosurgery at the time, which restricted radiosurgery to the treatment of intracranial tumors.  In 1990, Accuray Incorporated was founded.

Accuray first received FDA clearance for the CyberKnife System in 1999 for the treatment of tumors in the head, neck and upper spine. Then in 2001, the company received FDA clearance to introduce enhancements to the CyberKnife System for the treatment of tumors anywhere in the body.

COMPANY MILESTONES

1987 The CyberKnife System is developed
 
1990 Accuray Incorporated is founded.
 
1996 Japan approves the CyberKnife System for tumors in the head and neck.
 
1999 Food and Drug Administration (FDA) clears the CyberKnife System for the treatment of tumors in the head, neck and cervicothoracic spine.
 
2001 FDA clears enhancements to the CyberKnife System for tumors anywhere in the body.
 
2002 Europe approves the CyberKnife System for tumors anywhere in the body.
FDA clears Accuray’s Synchrony Respiratory Tracking System.
 
2003 Korea approves the CyberKnife System for tumors anywhere in the body.
 
2004 Taiwan approves the CyberKnife System for tumors anywhere in the body.
FDA clears Xsight Spine Tracking System.
5,000 patients treated using CyberKnife Radiosurgery. 
 
2005 10,000 patients treated using CyberKnife Radiosurgery.
FDA clears 4D Treatment Optimization and Planning System.
 
2006 Accuray opens new manufacturing and R&D facility.
FDA clears Xsight Lung Tracking System
20,000 patients treated using CyberKnife Radiosurgery.
 
2007 Accuray common stock begins trading on The NASDAQ Stock Market under the symbol ARAY.
40,000 patients treated using CyberKnife Radiosurgery.
100th CyberKnife System installed worldwide.
 
2008 Japan approves the CyberKnife System for treatment of tumors anywhere in the body.
50,000 patients treated using CyberKnife Radiosurgery.
150th CyberKnife System installed worldwide.
 
2009 Accuray announces the CyberKnife VSI System, which extends its radiosurgery capabilities to include high precision radiation therapy and Robotic IMRT™.  
80,000 patients treated using CyberKnife Radiosurgery.