The CyberKnife treatment plan involves five steps:
1) Consultation
A Radiation oncologist and other physicians determine if a patient is eligible, and, if the size and types of tumors or lesions could benefit from CyberKnife treatment.
2) Treatment Planning
Diagnostic images of the lesion are first taken. CT images are used and can be fused with MRI, PET, and 3D Angio images. Once the treatment volumes are defined, the physicist generates the treatment plan to deliver on the following clinical objectives.
3) Setup
For an intracranial lesion:
The radiation therapist will outfit the patient with a thermoplastic mask that conforms to the patient's face and positions the patient's head during treatment.
For a spinal lesion:
Either the neurosurgeon or the interventional radiologist will implant 3-5 small stainless steel markers in or near the lesion. These markers are used by the CyberKnife Tracking System to target the lesion and maintain targeting during treatment.
For a “soft tissue” lesion:
If the patient has a soft-tissue lesion, the surgeon or interventional radiologist will implant 3-5 markers in or near the lesion.
For lung, liver, pancreatic lesions, or any lesion that moves with respiration, the patient will also be outfitted with the synchrony tracking vest.
4) Administering Treatment
On the day of treatment, patients can wear comfortable clothing (and no jewelry). During treatment, no sedation or anesthesia is required because the treatment is painless.
The treatment itself involves the administration of radiation beams delivered from multiple directions. Prior to the delivery of each radiation beam, the image-guidance system takes x-ray images and compares them to the original CT scan. This information ensures that radiation is targeted directly at the tumor while avoiding healthy structures. The robotic arm then moves into position to deliver the radiation beams.
Once treatment has been completed, patients generally leave the CyberKnife suite and resume normal activity immediately following the procedure.
5) Follow-up Visit
After a treatment or series of treatments is administered, the patient returns three to six months later for a visit to determine progress. Evaluation often includes an MRI at this time.