How is cancer treated with CyberKnife®M6?
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In order to make a decision about the most suitable treatment, you may be referred to additional diagnostics. The necessary diagnostics will be specified by a radiologist during the consultation. Most often patients need to take an additional CT or MRI scan, less often — positron emission tomography.
Only after a comprehensive assessment of the situation our specialists will decide further treatment with CyberKnife as a separate method or in conjunction with other treatment methods.
We have set up a multidisciplinary tumour board of specialists at Sigulda Hospital, which makes decisions about potentially best therapy in each individual situation.
For example, to assess the case of central nervous system (CNS) cancer, also brain metastases from breast cancer, prostate cancer, melanoma, renal cancer or other cancers, the tumour board consists of neurologist, neurosurgeon, radiologist, radiation oncologist and medical oncologist, while in case of primary prostate cancer and renal cancer the tumour board consists of urologist, radiation oncologist and medical oncologist.
This approach promotes better assessment of all possible, alternative treatment methods in case of particular patient and allows ensuring high therapeutic quality in each situation where radiosurgery is required or where it has to be combined with other treatment methods.
Computed tomography and magnetic resonance imaging topometry is performed to prepare a radiosurgery plan. If specific preparation is be needed before the topometry, radiation therapy technician will let you know.
Any patient will have personal immobilization tools made before the computed tomography topometry to prevent from moving during the therapy:
• If radiosurgery is applied to head, an individual thermoplastic mask fitting the face contours will be made;
• If radiosurgery is applied to other part of the body or organ, a vacuum bag fitting the shape of the body will be made.
When immobilisation tools are ready, patients undergo a computed tomography (CT) scan in a posture intended for the therapy.
3 Tesla magnetic resonance imaging scan is also a frequent examination within topometry, because it provides maximally high resolution images with clearly visible contours of organs and tumour. The examination is made according to certain parameters, i.e. specially prepared CyberKnife protocol.
Some patients, in order to increase precision of the radiosurgery, have gold markers placed in the prostate or other soft tissue of the body prior to topometry. Placement of markers is minimally invasive procedure performed by urologist, thoracic surgeon or abdominal surgeon, assisted by a radiation oncologist.
If a special preparation is needed before placement of markers (blood test, preparation of bladder and intestinal tract) a radiation therapy technician will tell about it timely.
Preparation of individual therapy plan includes drawing of target volume and critical nearby organs, calculations of individual radiosurgery plan and dosimetric testing of the plan. Radiosurgery is planned in a specialised stereotactic radiosurgery computer-aided treatment planning system MultiPlan® or Precision®.
Total period of preparation and testing of radiosurgery plans varies from patient to patient, because it is created from images of previous examinations (CT scan, MRI scan, PET scan). It may take 1-5 days to prepare the plan.
During each procedure a patient is positioned on a therapy table with individual immobilisation tools, created before topometry. Body position is adjusted on the basis of images generated by x-ray imaging system located in the procedure room. Once the patient's position is verified, delivery of ionising radiation dose takes place according to the individual radiosurgery plan.
The only task of the patient during the procedure is to relax and lie as still as possible. There are no unpleasant sensations during the therapy — nothing is “baked” or “burnt”.
Radiosurgery treatment course with the CyberKnife system usually takes place in working days and on out-patient basis. You can return home the same day after the procedure.
Depending on your diagnosis, the treatment is included in 1-5 sessions. Duration of one therapy session routinely lasts around 1 hour, and total time spent in the hospital is up to 2 hours.
The treating doctor will prepare a therapy conclusion with recommendations for the first three months of the post-treatment period, as well as information about possible side effects in the end of the therapy.