Cyberknife Treatment for Skull Base Cancer

Skull base cancer tumors are often amorphous and invasive, difficult to remove with traditional scalpel surgery. The Cyberknife is a robotic radiosurgery system that delivers extremely accurate beams of high-dose radiation to tumors. Unlike traditional brain surgery, the Cyberknife is non-invasive, requiring no surgical opening of the skull. The Cyberknife was approved by the FDA in 1999 for the treatment of tumors in the head, neck and upper spine, and in 2001 for the treatment of other tumors.

Preparation

• Prior to undergoing Cyberknife treatment for skull base cancer, the patient will be fitted with a special mask designed to help the patient remain still during the treatment. The mask is made of soft mesh and fitted exactly to the patient. At the same time the mask is fitted, the patient will undergo a CT scan, which will help the physician determine the exact location and characteristics of the tumor. An MRI, PET scan or angiogram may also be performed at this time.

  Once all the test results are in, the patient's doctor or doctors will form a plan of treatment. Test results will be entered into the Cyberknife software and doctors will decide where to concentrate the radiation and note places to avoid radiating. They'll also decide how many sessions the patient will need.

Treatment

• The patient returns for the first treatment, lies on a table and dons the mask. The patient can wear comfortable clothes and may even be allowed to listen to favorite music during the treatment. While the patient lies still, the robotic arm of the Cyberknife moves around the patient and delivers treatment.

  The Cyberknife uses robotic technology to track the tumor in real time. During treatment, the Cyberknife can adjust for any movement of the tumor. Unlike traditional radiation treatments, which damage or destroy good tissue along with the cancerous tissue, the Cyberknife targets only the tumor or lesion.

  Patients who undergo Cyberknife surgery may first be treated with chemotherapy to shrink tumors. Depending on the type and location of the tumor, patients may undergo one or more Cyberknife sessions.

  Cyberknife radiosurgery requires no anesthesia. Patients should experience no pain during surgery and many people have no side effects. Some people experience mild fatigue or nausea, which should dissipate within a week or two.

Results

• A Chinese study conducted in 2006 and 2007 of 28 patients who received Cyberknife treatment for skull base tumors found that 17 of the tumors were stabilized and in 10 cases the tumors shrank. In three of those cases, the majority of the tumor disappeared. None of the patients suffered any neurological defects in the three months following treatment.