Advantages of Choosing CyberKnife for Brain Tumors: A Radiation Oncologist's In-Depth Explanation & How It Achieves Sub-Millimeter Precision

Understanding CyberKnife

CyberKnife is the world's first automated robotic radiosurgery system, perfectly embodying Stereotactic Body Radiotherapy (SBRT) principles. It delivers high-precision, personalized treatment solutions suitable for most solid tumors throughout the body.

This dedicated system for stereotactic radiosurgery is characterized by its accuracy, patient comfort, versatility, and safety. It can replace traditional surgery for tumors in various locations, aiming to eradicate early-stage tumors with just 1-5 treatment sessions.

Featuring a flexible robotic arm with synchronized respiratory tracking, the CyberKnife can select beam paths from multiple directions for stereotactic, focused irradiation. This delivers high doses to the tumor while minimizing damage to surrounding healthy tissue, achieving sub-millimeter precision and optimal organ-at-risk protection.

Our center has vast experience with countless patients treated. Below are typical brain tumor cases showcasing its remarkable results.

Case 1 Lung Cases Show

Patient: 76-year-old male presented with unexplained headaches, characterized as paroxysmal distending pain lasting several minutes per episode, accompanied by dizziness (non-vertiginous), and a sensation of head heaviness and discomfort. No nausea, vomiting, visual blurring or diplopia, tinnitus, hearing loss or deafness, slurred speech or dysphagia, water brash, limb convulsions, impaired consciousness, fever, or profuse sweating. Received intravenous therapy at a local hospital without significant improvement.

Admission Findings: Cranial CT showed multiple lacunar infarcts/encephalomalacia foci in bilateral basal ganglia and corona radiata. High-density focus in the left occipitoparietal lobe and low-density focus in the left temporal lobe; metastasis could not be ruled out.

Clinical Challenge & Highlight:Surgical targeting of multiple brain metastases is difficult due to their scattered distribution, making it challenging for traditional surgery to locate all lesions and potentially leading to missed targets. Furthermore, if tumors are located in critical brain areas (e.g., motor or language cortex), surgery carries a high risk of damaging surrounding healthy tissue, potentially causing severe neurological deficits like paralysis or aphasia. CyberKnife can track tumor position in real-time, accurately target multiple brain metastases, and minimize damage to normal brain tissue.

Radiotherapy Dose: 36Gy in 6 fractions of 6Gy each.

Treatment Outcome & Follow-up:CyberKnife provided a painless treatment without complications; the patient experienced no discomfort during the procedure. Post-treatment review showed significant shrinkage of the high-density focus. A 6-month follow-up examination confirmed further marked tumor reduction compared to previous scans.

Case 2

Patient: A 58-year-old male with a 3-year history of diagnosed small cell lung cancer. Recent cranial MRI review revealed a lesion measuring approximately 4.2*3.2*4.4 cm in the right occipital lobe, consistent with MRI findings of lung cancer brain metastasis.

Clinical Challenges:Surgical intervention faced difficulties in completely removing the metastatic lesions and carried a high risk of damaging surrounding critical nerves and blood vessels. For patients with brain metastases in weaker physical condition, CyberKnife's non-invasive and painless treatment approach effectively controls tumor growth. It delivers high-dose radiation to the tumor within a short period, effectively destroying tumor cells while reducing the radiation dose to normal tissues and lowering the risk of radiation-induced brain injury.

Radiation Dose: 36Gy/6Gy/6F

Treatment Outcomes and Follow-up:The patient underwent CyberKnife treatment at our hospital in January 2024 and experienced no discomfort during the treatment. Regular follow-up examinations after treatment showed tumor shrinkage at 3 months, further reduction at 6 months, and complete disappearance of the tumor after 1 year and 1 month.

Case 3

Patient: Elderly female presenting with an intracranial space-occupying lesion accompanied by seizures for 5 months. CT scan revealed a nodular focus in the left parietal lobe with surrounding edema, age-related brain changes, multiple intracranial ischemic foci, infarctions, and encephalomalacia. A nodular focus in the right middle lung lobe was considered suspicious for malignancy.

Clinical Challenges:The metastatic tumor demonstrated infiltrative growth with ill-defined borders against surrounding brain tissue, making accurate determination of the resection margin difficult. Incomplete resection carries a high risk of recurrence. Additionally, the patient's advanced age, generally poor physical condition, late-stage tumor status, and potential comorbid organ dysfunction reduced tolerance for surgery, significantly increasing operative risks. CyberKnife treatment, being non-invasive, avoids surgical trauma and associated complications. It is particularly suitable for patients in poor health or those who cannot tolerate surgery, and the entire treatment process is relatively short.

Radiotherapy Dose: 36Gy in 6 fractions of 6Gy each.

Treatment Outcome and Follow-up:The patient underwent CyberKnife treatment on June 28, 2024, and experienced no discomfort during the procedure. A follow-up examination over three months post-treatment showed that the high-density focus had essentially disappeared.

CyberKnife for Malignant Brain Tumors

CyberKnife is an advanced whole-body stereotactic radiosurgery system with unique advantages in treating brain tumors. It enables precise tumor localization through real-time image guidance technology that tracks tumor position during treatment, delivering accurate radiation to the tumor while causing minimal damage to surrounding healthy brain tissue. As a non-invasive treatment requiring no craniotomy, it avoids the trauma and bleeding risks associated with conventional surgery, significantly reducing patient discomfort. The procedure doesn't require invasive frame fixation, ensuring high patient comfort with no anesthesia or incisions needed. Patients experience quick recovery and can return home immediately after treatment. Even for irregularly shaped brain tumors, its non-isocentric radiation beam delivery enables optimal dose distribution.

Key Features of CyberKnife for Malignant Brain Tumors:

1.Precision: Delivers sub-millimeter accuracy using image guidance technology with dual orthogonal X-ray imagers to continuously correct for tumor motion, ensuring precise radiation targeting.

2.Non-invasive: Requires no surgical incisions or craniotomy, significantly reducing risks of infection, bleeding, and other surgery-related complications.

3.Broad Applicability: Effective for various brain tumors including metastatic and primary malignant tumors (e.g., astrocytoma), benign tumors (e.g., meningioma, acoustic neuroma), and tumors in deep-seated or eloquent brain areas where complete surgical resection is challenging.

4.Fractionated Treatment: Allows either single or multiple fraction treatments (typically 2-5 fractions), reducing damage to sensitive structures like cranial nerves and eyes.

5.High Safety: Extensive clinical practice and literature demonstrate effective tumor control in most (91%) intracranial tumor patients with low complication rates. Fractionated radiosurgery also shows good outcomes for tumors near the optic nerve.

Advantages of CyberKnife:

CyberKnife has a wide application range, treating tumors throughout the body (except hollow organs) including head and neck tumors, liver cancer, lung cancer, pancreatic cancer, metastases, and soft tissue sarcomas. Additionally, it effectively treats various intracranial benign conditions such as meningioma, pituitary adenoma, acoustic neuroma, craniopharyngioma, and trigeminal neuralgia.

Compared to conventional radiotherapy, CyberKnife offers significant advantages:

1.Greater Precision: Real-time tracking and continuous correction of tumor movement through image guidance keeps treatment errors within 1mm, far superior to other treatment methods.

2.Enhanced Comfort: With sophisticated tracking software, it eliminates the need for invasive head frame fixation used in other radiotherapy systems, allowing patients to breathe normally and remain relaxed during treatment.

3.Broader Capability: Indications cover various tumors throughout the body, including curative treatment for early-stage small tumors, palliative treatment for metastases, and local dose escalation after other radiotherapy.

4.Improved Safety: The sophisticated robotic planning system precisely "paints" the tumor volume, avoiding damage to surrounding normal organs and tissues, resulting in fewer radiation side effects.

CyberKnife represents a surgical alternative technology suitable for non-invasive treatment of both benign and malignant tumors. As the only comprehensive radiosurgery system integrating the advantages of "no incision, no pain, no bleeding, no anesthesia, and short recovery time," it provides a painless, non-surgical treatment option for patients who are inoperable, have difficult-to-resect tumors, or seek alternatives to surgery, offering new hope for cancer patients.