How the CyberKnife treatment is done
1 Referral and appointment scheduling
The CyberKnife treatment always demands a referral from a doctor. An oncologist always evaluates the patient’s suitability for the CyberKnife treatment.
When treating neurosurgical targets the doctor in charge is a neurosurgeon and the referral will be directed to KUH NeuroCenter.
Oncologist´s appointment and all other necessary appointments for the first visit will be informed to the patient by information letter.
2 Oncologist´s appointment
At the appointment, oncologist will specify the radiotherapy delivery method and the upcoming schedule.
3 Gold fiducials for tracking the target.
Certain treatments require fiducial markers inside the tumor or its proximity and they are placed in local anesthesia. These markers are used for tracking the target position during the treatment.
4 Fixation device for the treatment
While treating intracranial or head-and-neck area targets, the thermoplastic mask will be created to keep the head still during the treatment. The mask will be created at the first appointment, before the CT-scan.
5 Planning imagingt
Planning of the CyberKnife treatment always requires a CT-scan. CT-scan is taken after the oncologist´s appointment. For accurate target positioning, other imaging methods like magnetic resonance imaging (MRI) or angiography are also required.
6 Planning the CyberKnife treatment
After the oncologist´s appointment and planning imaging, the technical treatment planning begins. Physicist works together with oncologist and creates an individual dose plan to the target. Usually there´s approx. one week time reserved for the planning.
In the treatment the patient is positioned to the treatment couch exactly in the same position as in the CT-scan. The patient’s position should be relaxed for staying still during the treatment. While the treatment is on, breathing can be normal.
Patient can listen the radio, favourite music from the CD or mp3-player etc. during the treatment..
Therapists will monitor the patient in the treatment room via CCTV cameras. There is also an audio connection between treatment room and control room.
8 Fractioning of the treatment
Due the CyberKnife´s accuracy, delivered doses for one fraction can be higher than in conventional radiotherapy. Therefore the treatment period contains from 1 to 6 treatment fractions. Usually treatment fractions are delivered every other or every third day.
For example, the prostate radiotherapy period with CyberKnife will contain 5 treatment fractions and the period will be delivered within two weeks.
9 Side effects
Side effects on CyberKnife treatment are usually milder than in conventional radiotherapy. Side effects are local and related to the treatment target. For example, while treating a target in abdominal or pelvic area, the typical side effects are the symptoms in the bladder or in the bowels. Oncologist will brief the patient about the side effects before the treatment period.
10 Follow-up after the treatment
At the end of the treatment period the patient will have an appointment with the oncologist where the patient´s well-being is checked and the follow-up location and the date are set.