How does the CyberKnife treatment work?

CyberKnife^® treatment is a radiosurgical procedure that utilizes a linear accelerator to generate radiation beams precisely targeted at the site of the tumor or other area of concern.

After treatment, when will my tumor or lesion disappear?

The effects of radiosurgery occur gradually over a period of time. The time frame may range from days, months or even years depending on the medical condition targeted. Some tumors resolve more slowly than others and may or may not eventually disappear completely, while others simply stop growing and present no further biologic activity. After CyberKnife treatments patients typically have periodic follow-up imaging examinations, such as CT, MRI or PET studies, as deemed appropriate by their medical team, to assess their progress. Laboratory tests may also be ordered.

How can I determine if CyberKnife is a treatment option for me or my patient?

CyberKnife Center of Louisiana conducts regularly scheduled Cyberknife-specific case conferences, as well as, participation in bi-monthly oncology “tumor board” conferences in which a multidisciplinary team of physicians review the unique history and conditions of each patient before delivering a medical opinion. A patient and / or a physician who provides our CyberKnife Center Nurse with a patient’s demographics, insurance, history & physical, past treatment records, medication list, a pathology report and the applicable imaging (CT, MRI, or PET scans – preferably on CD) will receive a complimentary opinion by the next business day following the case conference. With a signed consent for release of medical records from the patient, our CyberKnife nurse may request records & images for a patient from other healthcare providers for the purposes of a review. Most opinions are given within the next business day following the case conference. In some cases, additional information may be requested prior to giving an opinion. To expedite a review, a patient’s documentation (noted above) may be faxed to the Cyberknife Nurse, and the related diagnostic images may be mailed to the Center at the following mailing address:

155 Hospital Dr., Ste. 102, Lafayette, LA 70503

Note: Healthcare providers may call our Center to schedule a courier to pick up records & images from local healthcare providers. For delivery of out-of-town patient images, ask about our next day account mail service.

How many procedures have been performed using the CyberKnife^® Robotic Radiosurgery System?

The FDA-approved CyberKnife System has been used to treat over 50,000 patients worldwide. More than half of these patients are treated for conditions outside of the brain/head.

How much does a Cyberknife treatment cost?

Medicare, Medicaid and most managed care plans cover stereotactic radiosurgery (SRS) – the term that most payors recognize. Each patient will have a different cost due to the unique treatment plan involved for each diagnosis and the patient’s insurance plan/coverage. Some payors require precertification and clinical information prior to a patient’s pretreatment set up. The Cyberknife Center staff precertify each patient’s setup, scan and treatment and notify the patient when the payor has given authorization or if there are any concerns or extended delays. Patients are also highly encouraged to contact their health insurance company prior to their pretreatment set up appointment to inquire about coverage and expected costs. If you consulted with a radiation oncologist and a CyberKnife-trained surgeon, then each of these physician consults/visits are separate from your treatment costs. Any patient who desires more information on the hospital’s specific charges and out-of-pocket costs, may request an appointment with one of our financial counselors in the hospital’s business office to discuss this in detail. Any questions about your surgeon or radiation oncologist charges should be addressed with the physician’s office manager.

Intensity Modulated Radiation Therapy (IMRT) differ from robotic radiosurgery and the CyberKnife System?

IMRT, Intensity Modulated Radiation Therapy, is a form of radiation therapy incorporating multi-leaf collimators on standard gantry-based linac delivery systems to better “shape” the radiation beams to the lesion volume. This is generally accepted as an improvement over conventional radiation therapy (XRT) systems, however it is still limited by many of the same constraints as conventional radiation therapy.

IMRT differs from CyberKnife radiosurgery in several fundamental ways:

• Accuracy — IMRT systems register target location only at the beginning of a treatment and cannot localize and automatically compensate for a moving target during the actual treatment. The CyberKnife System combines image guidance and computer controlled robotics to continuously track, detect and automatically correct for tumor and patient movement throughout the treatment, providing far greater accuracy when compared to an IMRT system and other systems.
• Fractionation — Due to the large error margin and the need to minimize damage to the surrounding healthy tissue, IMRT cannot deliver high doses of radiation (8-25 Gy per fraction). As a result, a higher number of treatment fractions (20-30 sessions) are delivered at a lower radiation dose (typically 2 Gy per fraction). Because the CyberKnife System is able to target and treat lesions more precisely, radiation doses can be increased and the number of fractions can be reduced to five or less.
• Flexibility — Compared to gantry-based IMRT, IGRT (Image Guided Radiation Therapy) and conventional radiosurgery systems, the CyberKnife System allows for greater flexibility. The robotic arm can be positioned in almost any orientation, providing maximum treatment delivery options compared to the constrained geometry of the gantry-based systems. The flexibility of the CyberKnife System helps the clinician to easily execute complex treatment plans, including those for non-symmetrical, complex-shaped lesions in difficult-to-reach locations. Less maneuverable systems make it difficult to achieve the same level of conformality and accuracy.

What can I expect during a Cyberknife treatment?

See the patient education video to learn more about specific treatment processes under this website’s main page “How it Works” or request a copy of the video on DVD from CyberKnife Center of Louisiana.

What is stereotactic radiosurgery?

Stereotactic radiosurgery is a non-surgical, non-invasive and painless treatment in which high doses of focused radiation beams are delivered from multiple locations outside the body to destroy a tumor or lesion within the body. This procedure does not remove the tumor or lesion. Instead, it destroys tumor cells or stops the growth of active tissue.

What is Synchrony?

Unlike lesions of the brain and spine, tumors in and near the lung move with breathing. One way to treat these moving tumors is to have patients hold their breath when the radiation beam is on to minimize large movements of the tumor and reduce unwanted irradiation of surrounding healthy tissue. However, breath-holding can be difficult for some patients, requires larger treatment margins around the tumor, and prolongs treatment time.

The Synchrony System is an enhancement that works together with the CyberKnife System to deliver dynamic radiosurgery—the ability to irradiate a tumor or other target while it is moving. The advantage of the Synchrony System is that patients can breathe normally throughout treatment while the CyberKnife robot actively compensates for the breathing motion during irradiation – this allows extremely accurate radiation delivery without the need for breath holding. Treatment is thus more comfortable for patients and significantly faster. The Synchrony System is used in conjunction with the CyberKnife to treat patients with tumors and lesions in areas of the body such as the lung, liver, kidney and pancreas.

What is the average treatment time for the CyberKnife system?

The treatment time per session ranges from 30 to 120 minutes depending on the dose delivered, the complexity of the tumor shape and the location. Physicians may elect to treat a patient with a single treatment or 2-5 treatments or fractions.

Will my hair fall out or will my skin burn after CyberKnife treatment?

The radiation delivered by the CyberKnife is so focused on a specific target that it is highly unlikely that hair loss or skin burn will occur. In the event that a treated lesion is very close to the scalp or skin though, the adjacent hair or skin may be affected. If so affected, this hair or skin will typically recover over time. All medical procedures, including CyberKnife treatment, have potential side effects and associated risks, and every patient will be individually evaluated and counseled in detail before a final plan of treatment is made. Any and all questions by the patient and their family will be answered before we proceed with treatment.