CyberKnife Radiotherapy

CyberKnife® is an advanced robotic radiation therapy system that delivers stereotactic radiotherapy (SABR/SBRT) with exceptional precision. Despite its name, it is not surgery and there are no incisions, scalpels or anaesthetic involved.

CyberKnife uses a compact linear accelerator mounted on a robotic arm to deliver hundreds of precisely targeted radiation beams from many different angles. During treatment, sophisticated imaging continuously checks the tumour's position and automatically adjusts for movement, helping maintain accuracy throughout the procedure.

CyberKnife can treat tumours almost anywhere in the body, including the brain, spine, lung, liver, pancreas, prostate and kidney.

For many patients, CyberKnife offers an effective non-invasive alternative to surgery, particularly when an operation would be difficult or carries significant risks.

No. Although the name includes the word "knife," CyberKnife is not an operation. There are:

• No cuts or incisions
• No general anaesthetic
• No stitches
• No hospital admission for surgery
• No surgical recovery

Instead, highly focused radiation is delivered from outside the body while you lie comfortably on the treatment couch. Most patients return home shortly after each treatment session.

CyberKnife combines several advanced technologies into one treatment system, including:

• Robotic radiation delivery
• Real-time X-ray imaging
• Computer-guided treatment planning
• Automatic tumour tracking
• Continuous correction for patient movement

During treatment, the system repeatedly checks the tumour's position. If the tumour moves because of breathing or small body movements, the robotic arm automatically adjusts the radiation beam to maintain accuracy. This allows high doses of radiation to be delivered while minimising exposure to nearby healthy tissues.

CyberKnife is used to treat a wide range of benign and malignant conditions. Common indications include:

• Early-stage lung cancer
• Brain tumours
• Brain metastases
• Prostate cancer
• Liver tumours
• Kidney cancer
• Pancreatic cancer
• Spine tumours
• Adrenal tumours
• Recurrent cancers
• Selected head and neck cancers
• Oligometastatic disease

Not every patient requires CyberKnife. Your radiation oncologist will recommend the treatment approach that is most appropriate for your individual situation.

No. CyberKnife is also used to treat several non-cancerous conditions, including selected:

• Meningiomas
• Acoustic neuromas (vestibular schwannomas)
• Arteriovenous malformations (AVMs)
• Trigeminal neuralgia
• Benign spinal tumours

The suitability of CyberKnife depends on the condition being treated and the expertise available at your treatment centre.

Yes. One of CyberKnife's unique features is its ability to track tumours that move during breathing.

For cancers in the lung, liver and upper abdomen, specialised imaging detects tumour movement and the robotic arm adjusts the radiation beam accordingly. This allows treatment to remain highly accurate while reducing radiation exposure to surrounding healthy tissues.

Not every patient requires respiratory tracking, and different centres may use different motion management techniques depending on the cancer being treated.

Before treatment, imaging is performed to confirm the exact position of the tumour. You then lie on the treatment couch while the robotic arm moves around you, delivering radiation from multiple angles.

The treatment is painless. Unlike some other stereotactic systems, the robotic arm moves throughout treatment to optimise the delivery of radiation.

Treatment sessions typically last between 30 and 90 minutes, depending on the complexity of the plan.

You cannot feel the radiation during treatment. Some people experience fatigue or mild treatment-related side effects over the following days or weeks, depending on the area treated, but the treatment itself is painless.

Not necessarily. Both CyberKnife and modern linear accelerators (LINACs) can deliver excellent stereotactic radiotherapy.

CyberKnife offers advantages for some situations, including continuous robotic tracking, treatment of moving tumours, highly flexible beam delivery, and some complex anatomical locations.

Modern LINAC systems also have important advantages, including faster treatment delivery, the ability to treat a wider range of cancers, advanced cone beam CT imaging, surface-guided radiotherapy, and adaptive treatment on selected systems.

There is no single "best" machine. The most appropriate technology depends on your diagnosis and treatment goals.

Although both treatments deliver stereotactic radiotherapy, they are designed for different purposes.

Gamma Knife is used exclusively for conditions within the brain and is considered one of the most accurate treatments available for many intracranial conditions. CyberKnife treats both brain and body tumours, including cancers of the lung, prostate, liver, pancreas and spine.

Gamma Knife uses multiple cobalt radiation sources focused on a single target, while CyberKnife uses a robotic linear accelerator that delivers radiation from many different positions. Both technologies achieve excellent outcomes when used for the appropriate indication.

Useful questions include:

• Is CyberKnife the best treatment for my cancer, or are there other options?
• Why have you recommended this treatment?
• How many CyberKnife patients does your team treat each year?
• What results have you seen for patients with my type of cancer?
• Will my case be discussed in a multidisciplinary meeting?
• How will tumour movement be managed during treatment?
• What side effects should I expect?
• What follow-up imaging will I need after treatment?
• Are there any clinical trials that might be appropriate for me?

An informed discussion with your radiation oncologist can help you understand the potential benefits, risks and alternatives so you can make the decision that is right for you.