UNC Health Talk

UNC Health Care expands treatment options with CyberKnife robotic radiosurgery system

Last week UNC Health Care began treating patients with the CyberKnife robotic radiosurgery system, a groundbreaking medical device that is designed to treat tumors anywhere in the body with sub-millimeter accuracy.

So far four patients have been treated with at UNC Health Care with this new state-of-the-art technology, which will now be available to additional patients as well.

“We have been performing radiosurgery at UNC for more than 15 years, but have been confined to treating tumors in the brain until now,” said Matthew Ewend, M.D., chief of neurosurgery. “In addition, all of our patients had to have a head frame or halo applied to treat the lesion. With the Cyberknife, we can treat a wider variety of lesions both in the brain and elsewhere in the body without having to apply the halo skull clamp. It’s a great step forward for our patients. Most importantly, we are now able to offer minimally invasive therapy to patients who previously had either no or only high risk treatment options.”

Patient benefits from the CyberKnife System are significant. It can be used to treat tumors previously considered inoperable, and many CyberKnife treatments can be performed on an outpatient basis. In addition, it is possible to treat multiple tumors at different locations in the body during a single or a limited number of treatment sessions. Patients routinely do not require general anesthesia and recovery periods are short.

This advanced radiosurgery system will allow surgeons and radiation oncologists at UNC Hospitals to treat tumors anywhere in the body. Only the Cyberknife can track, detect, and correct for patient movement in the middle of treatment for a tumor. This is a unique application not feasible with other existing radiosurgical technology. Part of a $4 million expansion of UNC Hospitals’ Radiation Oncology Department, the new CyberKnife Program is the first in North Carolina’s Triangle region and only one of 65 in the U.S. It is one of only 4 placed at a National Cancer Institute-designated Comprehensive Cancer Center.

CyberKnife robotic radiosurgery is a non-invasive and 100 percent frameless procedure. Since treatments can be delivered in single or fractionated sessions, the CyberKnife System offers optimum protection for adjacent normal critical structures. Unlike traditional radiosurgery devices, the CyberKnife System tracks internal reference points in the anatomy. In this way the CyberKnife System automatically tracks, detects and corrects for tumor and patient movement in real time, with updated image guidance at every beam position.

Dr. David Morris, director of the UNC Cyberknife Program, said the CyberKnife System “is able to treat many spinal tumors located in areas that are surgically difficult to access because of proximity to the spinal cord. It is also a valuable treatment option for patients who have received prior radiotherapy or who are not candidates for open surgery.”

While the CyberKnife System is revolutionary, it is far from experimental. More than 95 hospitals and medical centers worldwide now operate CyberKnife Centers. The CyberKnife has been used to treat more than 20,000 patients to date and over 150 peer-reviewed papers have been published documenting its efficacy. Developing a robotic radiosurgery program has been demonstrated to offer hospitals the opportunity to expand the options they provide to their patients by creating an entirely new referral pattern.

The Cyberknife system at UNC Hospitals is augmented with the Synchrony™ Respiratory Tracking System, the first technology in the world capable of delivering robotic radiosurgery to targets that move with respiration, such as lung, liver, kidney and pancreatic tumors. Traditional radiation treatment devices have a static approach to treatment delivery that is unable to compensate for the body’s natural motion. Synchrony literally synchronizes the CyberKnife System’s linear accelerator to the motion of the tumor, automatically adjusting and compensating for patient and tumor movement in real-time while delivering radiation. This advancement allows for significantly shorter treatment times compared to breath-holding and enables treatment of tumors anywhere in the body.

“The use of robotic compensation for respiratory movement is one of the most important advances in radiation oncology,” Morris noted. “Because of its ability to track tumors during the breathing cycle, we can reduce the amount of normal tissue receiving high doses of radiation. This allows us to complete treatment in fewer sessions, compared to multiple treatments over several weeks required by conventional radiation therapy. We look forward to exploring the benefits of this exciting tool to more effectively treat thoracic and abdominal tumors.”

Dr. Richard Feins, chief of thoracic surgery, said the CyberKnife “expands the treatment options for patients who would typically considered to be medically inoperable.”

The CyberKnife robotic radiosurgery system combines image guidance technology and computer controlled robotics, which enable the system to deliver high doses of radiation without a metal head frame while maintaining sub-millimeter accuracy. Because of its accuracy, flexibility and ability to track tumors, other areas of the body become treatable with robotic radiosurgery, such as the spine, lung, prostate, liver and pancreas. Because it is non-invasive, treatments can be delivered with more patient comfort and provides the physician’s the option to treat with in single or multiple fractions.

Media contact: Stephanie Crayton, (919) 966-2860 or scrayton@unch.unc.edu

The UNC Health Care System is a not-for-profit integrated health care system owned by the state of North Carolina and based in Chapel Hill. It exists to further the teaching mission of the University of North Carolina and to provide state-of-the-art patient care. UNC Health Care is comprised of UNC Hospitals, ranked consistently among the best medical centers in the country; the UNC School of Medicine, a nationally eminent research institution; community practices; home health and hospice services in seven central North Carolina counties; and Rex Healthcare and its provider network in Wake County.