Stereotactic Radiosurgery - CyberKnife

Why the Procedure Is Performed

SRS targets and treats an abnormal area. This minimizes damage to nearby healthy tissue. SRS is more likely to be recommended for people who are too high risk for conventional surgery. This may be due to age or other health problems. SRS may be recommended because the area to be treated is too close to vital structures inside the body.

CyberKnife is often used to slow the growth of small, deep brain tumors that are hard to remove during conventional surgery.

Tumors of the brain and nervous system that can be treated using CyberKnife include:

• Cancer that has spread (metastasized) to the brain from another part of the body
• A slow-growing tumor of the nerve that connects the ear to the brain (acoustic neuroma)
• Pituitary tumors
• Spinal cord tumors

Other cancers that can be treated include:

• Breast
• Kidney
• Liver
• Lung
• Pancreas
• Prostate
• A type of skin cancer (melanoma) that involves the eye

Other medical problems treated with CyberKnife are:

• Blood vessel problems such as arteriovenous malformations
• Parkinson disease
• Severe tremors (shaking)
• Some types of epilepsy
• Trigeminal neuralgia (severe nerve pain of the face)

Risks

SRS may damage tissue around the area being treated. As compared to other types of radiation therapy, CyberKnife treatment is much less likely to damage nearby healthy tissue.

Brain swelling may occur in people who receive treatment to the brain. Swelling usually goes away without treatment. But some people may need medicines to control this swelling. In rare cases, surgery with incisions (open surgery) is needed to treat the brain swelling caused by the radiation.

Before the Procedure

Before the treatment, you will have MRI or CT scans. These images help your doctor determine the specific treatment area.

The day before your procedure:

• Do not use any hair cream or hair spray if CyberKnife surgery involves your brain.
• Do not eat or drink anything after midnight unless told otherwise by your doctor.

The day of your procedure:

• Wear comfortable clothes.
• Bring your regular prescription medicines with you to the hospital.
• Do not wear jewelry, makeup, nail polish, or a wig or hairpiece.
• You will be asked to remove contact lenses, eyeglasses, and dentures.
• You will change into a hospital gown.
• An intravenous (lV) line will be placed into your arm to deliver contrast material, medicines, and fluids.

After the Procedure

Often, you can go home about 1 hour after the treatment. Arrange ahead of time for someone to drive you home. You can go back to your regular activities the next day if there are no complications, such as swelling. If you have complications, you may need to stay in the hospital overnight for monitoring.

Follow instructions for how to care for yourself at home.

Outlook (Prognosis)

The effects of CyberKnife treatment may take weeks or months to be seen. Prognosis depends on the condition being treated. Your provider will likely monitor your progress using imaging tests such as MRI and CT scans.

References

Accuray Incorporated website. CyberKnife Accuray general information, treatment overview. cyberknife.com/treatment/overview/general. Accessed September 29, 2017.

Linskey ME, Kuo JV. General and historical considerations of radiotherapy and radiosurgery. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 261.

Welling DB, Spear SA, Packer MD. Stereotactic radiation treatment of benign tumors of the cranial base. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 179.