Week 11 - CyberKnife Flashcards
what is cyberknife
delivers high dose beams of radiation with extreme precision to treat tumours and other lesions anywhere in the body
acoustic neuroma
- benign tumour of cells that surround the cranial nerve
- affects important nerves, brain, hearing, facial and balance
acoustic neuroma side effects
- tinnitus
- balance problems
- numbness, pain or weakness in face muscles
- vertigo
intracranial treatment sites
- brain tumours
- brain mets
- acoustic neuromas
- arteriovenous malformations (AVMs)
- trigeminal neuralgia
Discuss cyberknife for brain mets
- Treated within 4 days from consultation - removes treatment delay that causes patients significant stress
15 Brain METS
- Traditionally treat whole brain
- Metastatic brain cancer responds well to high dose in few fractions
- Treat mets as they appear
- Improved OS - few side effects
Explain the rationale for trigeminal neuralgia treatment using CyberKnife
Surgery for trigeminal neuralgia is invasive and extensive. If patient has tried medication and it does not work, will get referred for radiotherapy. Minimal side effects are seen and effective treatment.
What is the dose fractionation for trigeminal neuralgia for cyber knife?
62Gy for a single shot
Explain how acoustic neuroma’s are treated with CyberKnife
These benign tumours affecting the cranial nerve can be offered surgery or RT. ENT surgeon will complete 6 month imaging to assess growth. < 3cm diameter, not fit for surgery or residual acoustic neuroma after surgery can be treated. Contrast must be used to visualise these alongside MRI.
What is the dose fractionation for acoustic neuroma using cyberknife?
12.5 Gy in 1 #
Discuss how X-sight lung tracking works with CyberKnife
LED markers placed on patients chest are tracked using a camera to monitor breathing motion. The robotic arm tracks lesion to treat.
If it is non-intracranial or not x-sight a fiducial marker is required to be placed in or next to the tumour to use as a surrogate
Discuss the virtual brachytherapy boost for prostate cancer
Instead of using invasive brachytherapy which is lengthy in the treatment aspect and recovery, VBB can be used. For high grade prostate cancer, fiducial insertion by urologist, conventional IGRT VMAT 50.4Gy in 25 treatments then a 3 week break with spaceOAR insertion, then VBB with 19.5Gy/3 fractions
What is the dose gradient for cyber knife?
10% per mm
cyberknife H&N
can be used to treat a number of head and neck cancers, including some previously irradiated areas. can be used alone or in conjunction with other forms of therapy
cyberknife lung cancer
non surgical option for treating lung metastases, early stage, inoperable non small cell lung cancer, tumours in challenging anatomical locations such as central lung tumours surrounded by sensitive structures and lung tumours near the chest wall and inoperable peripheral lung tumours
cyberknife spinal lesion
is a non-invasive, non-surgical, pain-free treatment option for treating cancers and/or metastases throughout the spine - including complicated neurosurgical cases
