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csb069 > Cyberknife > Flashcards

Cyberknife Flashcards

1
Q

Difference between gamma and cyberknife

A

Does not require whole day stay
Does not require frames for treatment

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2
Q

Image matching process

A

6 algorithms, orthogonal imaging

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3
Q

Who conducts Simulation?

A

Radiographers conduct simulation —> reporting is done on imaging

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4
Q

How long does it take from consult to planning

A

4 days from consult, treatment can be started

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5
Q

What is cyberknife

A

Fully robotic, delivery of precisely targeted imaging and treatment, real time image guidance to deliver precisely targeted radiation to cancerous and non-cancerous lesions almost anywhere in the body

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6
Q

Components of cyberknife

A

6 axis robot, linear acceleration, couch
Mini-pencil beam linac - easy to calibrate
MLC head - round collimator cones, iris cones
X ray sources on ceilings
Synchrony detectors

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7
Q

Real time imaging

A

Therapists decide how many times there is imaging, all corrections are done by the robot

Real-time imaging done for difficult cases

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8
Q

Features

A

6MV
1000MU/min
0.3-0.8mm accuracy depending on tracking method

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9
Q

What is treated intracranial

A

brain tumours, benign, acoustic neuromas, trigeminal neuralgia, functional disorders, AVMs

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10
Q

Intracranial treatment success

A

SRS for patients with 2-4 BM
One BM OS: 13.9months
2-10 BM OS: 10.8 months

Treated within 4 days from consult

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11
Q

Trigeminal neuralgia treatment

A

Higher dose required as it is not a tumour
62GY in 1#
10% dose fall off every mm
Sitting next to a brain stem so needs to be highly conformal
Around 40mins for treatment
Can lead to facial palsy

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12
Q

Acoustic neuroma treatment

A

Benign tumour of cells that surround the cranial nerve
Typically <3cm diameter
CT with contrast 1mm slice
Before CK: some sensory neural hearing loss, episodic loss of balance
30-60min to deliver

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13
Q

Head and neck treatment

A

can be used alone or in conjunction with other forms of therapy
Used as boosts - reduces side effects

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14
Q

Lung treatment

A

non-invasive, early stage, inoperable NSCLC, tumours in challenging anatomical locations such as central lung, chest wall, peripheral lung tumours

OS and recurrence free survival much better than surgery
Breathing pattern tracked by robot

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15
Q

Treatment tracking for lung patients

A

Can lock on the disease without a Fiducial markers -> track and treat

If robot cannot see tumour- utilise Fiducial markers in these cases, does have risks of pneumothorax
Placed Fiducial next to the tumour- used as a surrogate
3DOF only for fiducials

X-Sight lung tracking - LED markers, camera and external breathing motion

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16
Q

Spinal tumours

A

24gy prescribed to 76% iso dose, 3# alternative days, 134 beams
International patients do not get alternative days, get it done asap

17
Q

Liver treatment

A

Liver Mets, primary HCC, 54Gy prescribed to 73% iso dose, 3 fractions, 207 beams

18
Q

Kidney treatment

A

primary and secondary tumours. Tracks kidney movement, extremely precise
39Gy prescribed to 70% iso dose
3 fractions

19
Q

Pancreas treatment

A

conjunction with other therapies such as surgery and chemo
Delivered in period of rest from chemo
Double the dose than normal RT
Chemo back on following RT

40Gy prescribed to 78% iso dose 5#
OS is much better with this

20
Q

Prostate treatment

A

Low intermediate and high grade prostate cancers
Treated in 5 fractions rather than 30 due to the low alpha beta ratio
Better sexual health outcomes
No bleeding or incontinence, patients see urologist

Recreate the dose distribution of Brachytherapy without the use of needles using cyberknife
Conventional VMAT 50.4gy in 25
Following space OAR insertion, VBB with 19.5gy IN 3 FRAC

21
Q

Metastatic disease

A

Lymph nodes, brain, spinal tumours
Sarcomas are radio-resistant: dose escalation, treated radio-surgically
More than 4 oligomets, require chemo
Following chemo, conventional RT treats the painful spots
However, cyberknife can treat multiple sites

22
Q

Abscopal theory

A

Body release antigens to kill other Mets following radiotherapy treatment to a different target

23
Q

Organs at risk

A

Brain stem max dose 15Gy
Eye max dose 1.5Gy
Optic nerves and orbits 8Gy

csb069 (10 decks)

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