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Sanford — With CyberKnife up and running at Central Florida Regional Hospital’s (CFRH) CyberKnife Center, physicians have another tool in their arsenal to fight tumors.

Designed to treat tumors anywhere in the body, the CyberKnife was developed in 1987 by Dr. John R. Adler, professor of neurosurgery and radiation oncology at Stanford University Medical Center.

In 1990, Adler together with a group from Stanford and a manufacturer of linac technology teamed up to establish Accuray, Inc., CyberKnife’s distributor.
The device received FDA approval in 1999 to treat tumors of the head and neck, followed by approval to treat tumors with CyberKnife anywhere in the body in 2004.

The only robotic radiosurgery system utilizing the skeletal structure of the body as a reference, eliminating the need for an invasive frame used with traditional radiosurgery systems, CyberKnife uses a combination of image guidance and computer controlled robotics to continuously track, detect and correct for tumor and patient movement throughout treatment.

Unlike conventional radiotherapy that irradiates tumors and surrounding healthy tissue, the CyberKnife uses multiple beams of radiation converging to focus precisely on their target. Because the beams heat only at their focal point, only the targeted tumorous tissue is destroyed, creating a non-invasive means of destroying tumors inaccessible to previous radiosurgical techniques.

Referring to CyberKnife as “doing surgery with radiation,” Dr. Greg Ortega, a practitioner in Sanford’s Mid-Florida Hematology/Oncology Group, views the device as a good addition to traditional therapy. “With CyberKnife, we’re able to treat a subset of patients who otherwise would have had limited surgical options, or had to leave town because we did not have the equipment to treat them locally.”

Since opening in April, 25 patients have been seen at CFRH’s $5 million CyberKnife Center and radiation oncologist, Dr. John W. Wells, Jr., has treated brain and central nervous system tumors including malignant and benign meningiomas.

“We’re excited about offering a sophisticated service to three million people in Central Florida who have radio resistant tumors and tumors near critical organs that have recurred after standard treatment,” said Wells.

In addition to preservation of healthy tissue surrounding the tumor, Wells noted that he sees a lessened degree of nausea in patients treated with CyberKnife versus standard radiation.

Depending on the complexity of the tumor shape and the dose of radiation delivered, treatment time per session ranges from 30 to 90 minutes, including patient setup, beam-on and beam-off. Physicians may elect to treat a patient with a single or hypofractionated dose over two to five sessions.

Giving kudos to the neurosurgeons who created CyberKnife, Wells said the device is ideal for treating smaller tumors, ranging in size from miniscule BB pellets to golf balls, at higher doses over a shorter period of time.

In the short time CyberKnife has been operational at CFRH, Wells has seen its magic work firsthand in a patient with metastatic liver cancer who had complete resolution of disease within a month of treatment.

Referring to CyberKnife as “a beautiful flexible system with real time image guidance and respiratory tracking…,” Dr. Allison Grow, director of the CyberKnife Center at CFRH, said the device is ideal for patients who, despite treatment with traditional radiation, have had a recurrence of disease.

Grow, who also directs the CyberKnife Center at Memorial Hospital of Jacksonville, recounted the story of a woman in her sixties who was diagnosed with carcinoma in situ in 1995. Ten years after her hysterectomy, she had a blood clot in her leg caused by a pelvic mass. Chemotherapy and a full dose of traditional radiation were used to treat the untractable tumor blocking kidney drainage.

Several months after traditional radiation treatment, the tumor began to grow again. Due to suppressed blood counts the patient could not have additional radiation or chemotherapy. Because surgery was not an option, Grow used the CyberKnife to treat the tumor and today, her patient is free from pain, has a negative PET scan and the mass is under control.



October 2007

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