Skip to main content
SpringerLink
Log in

Cyberknife, Dose Fractioning for Clinical Protocols

  • Chapter
  • First Online:
Laser-Driven Particle Acceleration Towards Radiobiology and Medicine

Part of the book series: Biological and Medical Physics, Biomedical Engineering ((BIOMEDICAL))

  • 952 Accesses

Abstract

Stereotactic radiotherapy (SRT) is a radiation technique initially designed for intracranial tumors which allows the delivery of hypofractionated treatment with high precision. This technique uses a multitude of small beams which creates a large dose gradient resulting in the delivery of high dose to the tumor while minimizing the dose to adjacent normal structures. As a result, stereotactic radiotherapy was more recently developed for extracranial tumors allowing a new method for delivering high doses in a single or limited number of sessions. The Cyberknife® is a noninvasive robotic image-guided system which delivers SRT with high level of accuracy due to its intrafraction motion detection and correction. Nowadays, SRT has become a standard of care for certain indications such as inoperable patients suffering from lung cancer for instance. Moreover, this technique seems promising for other indications such as liver lesions or reirradiation. Nevertheless, studies are needed to define the optimal fractionated scheme for each tumor location.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. S.D. Chang, W. Main, D.P. Martin, I.C. Gibbs, M.P. Heilbrun, An analysis of the accuracy of the CyberKnife: a robotic frameless stereotactic radiosurgical system. Neurosurgery 52, 140–146 (2003). discussion 146–147

    Google Scholar 

  2. E. Coste-Maniere, R. Simmons (2000) Architecture, the backbone of robotic systems. In: Proceedings of ICRA 00 IEEE International Conference Robotics and Automation 2000, vol 1, pp 67–72. doi:10.1109/ROBOT.2000.844041

  3. T. Gevaert, M. Levivier, T. Lacornerie, D. Verellen, B. Engels, N. Reynaert et al., Dosimetric comparison of different treatment modalities for stereotactic radiosurgery of arteriovenous malformations and acoustic neuromas. Radiother. Oncol. J. Eur. Soc. Ther. Radiol. Oncol. 106, 192–197 (2013). doi:10.1016/j.radonc.2012.07.002

    Article  Google Scholar 

  4. D. Greto, L. Livi, P. Bonomo, L. Masi, B. Detti, I. Meattini et al., Cyberknife stereotactic radiosurgery for the re-irradiation of brain lesions: a single-centre experience. Radiol. Med. (Torino) 119, 721–726 (2014). doi:10.1007/s11547-014-0383-2

    Article  Google Scholar 

  5. E. Shaw, C. Scott, L. Souhami, R. Dinapoli, R. Kline, J. Loeffler et al., Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: final report of RTOG protocol 90-05. Int. J. Radiat. Oncol. Biol. Phys. 47, 291–298 (2000)

    Article  Google Scholar 

  6. M.A. Vogelbaum, L. Angelov, S.-Y. Lee, L. Li, G.H. Barnett, J.H. Suh, Local control of brain metastases by stereotactic radiosurgery in relation to dose to the tumor margin. J. Neurosurg. 104, 907–912 (2006). doi:10.3171/jns.2006.104.6.907

    Article  Google Scholar 

  7. M. Scorsetti, A. Facoetti, P. Navarria, M. Bignardi, M. De Santis, S.A. Ninone et al., Hypofractionated stereotactic radiotherapy and radiosurgery for the treatment of patients with radioresistant brain metastases. Anticancer Res. 29, 4259–4263 (2009)

    Google Scholar 

  8. M.A. Manning, R.M. Cardinale, S.H. Benedict, B.D. Kavanagh, R.D. Zwicker, C. Amir et al., Hypofractionated stereotactic radiotherapy as an alternative to radiosurgery for the treatment of patients with brain metastases. Int. J. Radiat. Oncol. Biol. Phys. 47, 603–608 (2000)

    Article  Google Scholar 

  9. E.J. Hall, D.J. Brenner, The radiobiology of radiosurgery: rationale for different treatment regimes for AVMs and malignancies. Int. J. Radiat. Oncol. Biol. Phys. 25, 381–385 (1993)

    Article  Google Scholar 

  10. H. Aoyama, H. Shirato, R. Onimaru, K. Kagei, J. Ikeda, N. Ishii et al., Hypofractionated stereotactic radiotherapy alone without whole-brain irradiation for patients with solitary and oligo brain metastasis using noninvasive fixation of the skull. Int. J. Radiat. Oncol. Biol. Phys. 56, 793–800 (2003)

    Article  Google Scholar 

  11. A. Ernst-Stecken, O. Ganslandt, U. Lambrecht, R. Sauer, G. Grabenbauer, Phase II trial of hypofractionated stereotactic radiotherapy for brain metastases: results and toxicity. Radiother. Oncol. J. Eur. Soc. Ther. Radiol. Oncol. 81, 18–24 (2006). doi:10.1016/j.radonc.2006.08.024

    Article  Google Scholar 

  12. A. Fahrig, O. Ganslandt, U. Lambrecht, G. Grabenbauer, G. Kleinert, R. Sauer et al., Hypofractionated stereotactic radiotherapy for brain metastases–results from three different dose concepts. Strahlenther. Onkol. Organ Dtsch. Röntgenges. Al. 183, 625–630 (2007). doi:10.1007/s00066-007-1714-1

    Article  Google Scholar 

  13. Y.-J. Kim, K.H. Cho, J.-Y. Kim, Y.K. Lim, H.S. Min, S.H. Lee et al., Single-dose versus fractionated stereotactic radiotherapy for brain metastases. Int. J. Radiat. Oncol. Biol. Phys. 81, 483–489 (2011). doi:10.1016/j.ijrobp.2010.05.033

    Article  Google Scholar 

  14. A.C. Hartford, A.J. Paravati, W.J. Spire, Z. Li, L.A. Jarvis, C.E. Fadul et al., Postoperative stereotactic radiosurgery without whole-brain radiation therapy for brain metastases: potential role of preoperative tumor size. Int. J. Radiat. Oncol. Biol. Phys. 85, 650–655 (2013). doi:10.1016/j.ijrobp.2012.05.027

    Article  Google Scholar 

  15. G. Minniti, V. Esposito, E. Clarke, C. Scaringi, G. Lanzetta, M. Salvati et al., Multidose stereotactic radiosurgery (9 Gy × 3) of the postoperative resection cavity for treatment of large brain metastases. Int. J. Radiat. Oncol. Biol. Phys. 86, 623–629 (2013). doi:10.1016/j.ijrobp.2013.03.037

    Article  Google Scholar 

  16. J.S.-Y. Wu, R. Wong, M. Johnston, A. Bezjak, T. Whelan, Cancer care ontario practice guidelines initiative supportive care group, meta-analysis of dose-fractionation radiotherapy trials for the palliation of painful bone metastases. Int. J. Radiat. Oncol. Biol. Phys. 55, 594–605 (2003)

    Article  Google Scholar 

  17. P.C. Gerszten, S.A. Burton, C. Ozhasoglu, W.C. Welch, Radiosurgery for spinal metastases: clinical experience in 500 cases from a single institution. Spine. 32, 193–199 (2007). doi:10.1097/01.brs.0000251863.76595.a2

    Article  Google Scholar 

  18. B. Wowra, S. Zausinger, C. Drexler, M. Kufeld, A. Muacevic, M. Staehler et al., CyberKnife radiosurgery for malignant spinal tumors: characterization of well-suited patients. Spine. 33, 2929–2934 (2008). doi:10.1097/BRS.0b013e31818c680a

    Article  Google Scholar 

  19. I.C. Gibbs, P. Kamnerdsupaphon, M.-R. Ryu, R. Dodd, M. Kiernan, S.D. Chang et al., Image-guided robotic radiosurgery for spinal metastases. Radiother. Oncol. J. Eur. Soc. Ther. Radiol. Oncol. 82, 185–190 (2007). doi:10.1016/j.radonc.2006.11.023

    Article  Google Scholar 

  20. J.-T. Tsai, J.-W. Lin, W.-T. Chiu, W.-C. Chu, Assessment of image-guided CyberKnife radiosurgery for metastatic spine tumors. J. Neurooncol. 94, 119–127 (2009). doi:10.1007/s11060-009-9814-7

    Article  Google Scholar 

  21. A.M. Levine, C. Coleman, S. Horasek, Stereotactic radiosurgery for the treatment of primary sarcomas and sarcoma metastases of the spine. Neurosurgery. 64, A54–A59 (2009). doi:10.1227/01.NEU.0000339131.28485.4A

    Article  Google Scholar 

  22. A. Sahgal, C. Ames, D. Chou, L. Ma, K. Huang, W. Xu et al., Stereotactic body radiotherapy is effective salvage therapy for patients with prior radiation of spinal metastases. Int. J. Radiat. Oncol. Biol. Phys. 74, 723–731 (2009). doi:10.1016/j.ijrobp.2008.09.020

    Article  Google Scholar 

  23. A. Sahgal, D.A. Larson, E.L. Chang, Stereotactic body radiosurgery for spinal metastases: a critical review. Int. J. Radiat. Oncol. Biol. Phys. 71, 652–665 (2008). doi:10.1016/j.ijrobp.2008.02.060

    Article  Google Scholar 

  24. D.E. Heron, M.S. Rajagopalan, B. Stone, S. Burton, P.C. Gerszten, X. Dong et al., Single-session and multisession CyberKnife radiosurgery for spine metastases-University of Pittsburgh and Georgetown University experience. J. Neurosurg. Spine. 17, 11–18 (2012). doi:10.3171/2012.4.SPINE11902

    Article  Google Scholar 

  25. Haute Autorité de Santé - Radiothérapie extracrânienne en conditions stéréotaxiques, (n.d.). http://www.has-sante.fr/portail/jcms/r_1498752/fr/radiotherapie-extracranienne-en-conditions-stereotaxiques Accessed 8 Sept 2014)

  26. A. Muacevic, C. Drexler, B. Wowra, A. Schweikard, A. Schlaefer, R.T. Hoffmann et al., Technical description, phantom accuracy, and clinical feasibility for single-session lung radiosurgery using robotic image-guided real-time respiratory tumor tracking. Technol. Cancer Res. Treat. 6, 321–328 (2007)

    Article  Google Scholar 

  27. J.J. Nuyttens, J.-B. Prévost, J. Praag, M. Hoogeman, R.J. Van Klaveren, P.C. Levendag et al., Lung tumor tracking during stereotactic radiotherapy treatment with the CyberKnife: Marker placement and early results. Acta Oncol. Stockh. Swed. 45, 961–965 (2006). doi:10.1080/02841860600902205

    Article  Google Scholar 

  28. B.T. Collins, K. Erickson, C.A. Reichner, S.P. Collins, G.J. Gagnon, S. Dieterich et al., Radical stereotactic radiosurgery with real-time tumor motion tracking in the treatment of small peripheral lung tumors. Radiat. Oncol. Lond. Engl. 2, 39 (2007). doi:10.1186/1748-717X-2-39

    Article  Google Scholar 

  29. R.I. Whyte, R. Crownover, M.J. Murphy, D.P. Martin, T.W. Rice, M.M. DeCamp et al., Stereotactic radiosurgery for lung tumors: preliminary report of a phase I trial. Ann. Thorac. Surg. 75, 1097–1101 (2003)

    Article  Google Scholar 

  30. J.-E. Bibault, B. Prevost, E. Dansin, X. Mirabel, T. Lacornerie, E. Lartigau, Image-guided robotic stereotactic radiation therapy with fiducial-free tumor tracking for lung cancer. Radiat. Oncol. Lond. Engl. 7, 102 (2012). doi:10.1186/1748-717X-7-102

    Article  Google Scholar 

  31. W.T. Brown, X. Wu, F. Fayad, J.F. Fowler, B.E. Amendola, S. García et al., CyberKnife radiosurgery for stage I lung cancer: results at 36 months. Clin. Lung Cancer. 8, 488–492 (2007). doi:10.3816/CLC.2007.n.033

    Article  Google Scholar 

  32. J. Castelli, J. Thariat, K. Benezery, B. Padovani, D. Ducreux, N. Venissac et al., Feasibility and efficacy of cyberknife radiotherapy for lung cancer: early results]. Cancer Radiothérapie J. Société Fr. Radiothérapie Oncol. 12, 793–799 (2008). doi:10.1016/j.canrad.2008.06.002

    Article  Google Scholar 

  33. Q.-T. Le, B.W. Loo, A. Ho, C. Cotrutz, A.C. Koong, H. Wakelee et al., Results of a phase I dose-escalation study using single-fraction stereotactic radiotherapy for lung tumors. J. Thorac. Oncol. Off. Publ. Int. Assoc. Study Lung Cancer 1, 802–809 (2006)

    Google Scholar 

  34. C.W. Hurkmans, J.P. Cuijpers, F.J. Lagerwaard, J. Widder, U.A. van der Heide, D. Schuring et al., Recommendations for implementing stereotactic radiotherapy in peripheral stage IA non-small cell lung cancer: report from the Quality Assurance Working Party of the randomised phase III ROSEL study. Radiat. Oncol. Lond. Engl. 4, 1 (2009). doi:10.1186/1748-717X-4-1

    Article  Google Scholar 

  35. B.O. Choi, I.B. Choi, H.S. Jang, Y.N. Kang, J.S. Jang, S.H. Bae et al., Stereotactic body radiation therapy with or without transarterial chemoembolization for patients with primary hepatocellular carcinoma: preliminary analysis. BMC Cancer 8, 351 (2008). doi:10.1186/1471-2407-8-351

    Article  Google Scholar 

  36. G. Ambrosino, F. Polistina, G. Costantin, P. Francescon, R. Guglielmi, P. Zanco et al., Image-guided robotic stereotactic radiosurgery for unresectable liver metastases: preliminary results. Anticancer Res. 29, 3381–3384 (2009)

    Google Scholar 

  37. S. Dewas, J.-E. Bibault, X. Mirabel, I. Fumagalli, A. Kramar, H. Jarraya et al., Prognostic factors affecting local control of hepatic tumors treated by Stereotactic Body Radiation Therapy. Radiat. Oncol. Lond. Engl. 7, 166 (2012). doi:10.1186/1748-717X-7-166

    Article  Google Scholar 

  38. C. Vautravers-Dewas, S. Dewas, F. Bonodeau, A. Adenis, T. Lacornerie, N. Penel et al., Image-guided robotic stereotactic body radiation therapy for liver metastases: is there a dose response relationship? Int. J. Radiat. Oncol. Biol. Phys. 81, e39–e47 (2011). doi:10.1016/j.ijrobp.2010.12.047

    Article  Google Scholar 

  39. Z.-Y. Yuan, M.-B. Meng, C.-L. Liu, H.-H. Wang, C. Jiang, Y.-C. Song et al., Stereotactic body radiation therapy using the CyberKnife(®) system for patients with liver metastases. OncoTargets Ther. 7, 915–923 (2014). doi:10.2147/OTT.S58409

    Article  Google Scholar 

  40. K.A. Goodman, E.A. Wiegner, K.E. Maturen, Z. Zhang, Q. Mo, G. Yang et al., Dose-escalation study of single-fraction stereotactic body radiotherapy for liver malignancies. Int. J. Radiat. Oncol. Biol. Phys. 78, 486–493 (2010). doi:10.1016/j.ijrobp.2009.08.020

    Article  Google Scholar 

  41. J.-K. Kang, C.K. Cho, C.W. Choi, S. Yoo, M.-S. Kim, K. Yang et al., Image-guided stereotactic body radiation therapy for localized prostate cancer. Tumori. 97, 43–48 (2011)

    Google Scholar 

  42. S. Aluwini, P. van Rooij, M. Hoogeman, C. Bangma, W.J. Kirkels, L. Incrocci et al., CyberKnife stereotactic radiotherapy as monotherapy for low- to intermediate-stage prostate cancer: early experience, feasibility, and tolerance. J. Endourol. Endourol. Soc. 24, 865–869 (2010). doi:10.1089/end.2009.0438

    Article  Google Scholar 

  43. C. Choi, C. Cho, G. Kim, K. Park, M. Jo, C. Lee et al., Stereotactic radiation therapy of localized prostate cancer using cyberknife. Int. J. Radiat. Oncol. Biol. Phys. 69, S375 (2007)

    Article  Google Scholar 

  44. C.R. King, J.D. Brooks, H. Gill, T. Pawlicki, C. Cotrutz, J.C. Presti, Stereotactic body radiotherapy for localized prostate cancer: interim results of a prospective phase II clinical trial. Int. J. Radiat. Oncol. Biol. Phys. 73, 1043–1048 (2009). doi:10.1016/j.ijrobp.2008.05.059

    Article  Google Scholar 

  45. C.R. King, J.D. Brooks, H. Gill, J.C. Presti, Long-term outcomes from a prospective trial of stereotactic body radiotherapy for low-risk prostate cancer. Int. J. Radiat. Oncol. Biol. Phys. 82, 877–882 (2012). doi:10.1016/j.ijrobp.2010.11.054

    Article  Google Scholar 

  46. A.J. Katz, M. Santoro, R. Ashley, F. Diblasio, Stereotactic Body Radiation Therapy for Low- and Low-Intermediate-Risk Prostate Cancer: Is there a Dose Effect? Front. Oncol. 1, 49 (2011). doi:10.3389/fonc.2011.00049

    Article  Google Scholar 

  47. G. Voynov, D.E. Heron, S. Burton, J. Grandis, A. Quinn, R. Ferris et al., Frameless stereotactic radiosurgery for recurrent head and neck carcinoma. Technol. Cancer Res. Treat. 5, 529–535 (2006)

    Article  Google Scholar 

  48. D.E. Heron, R.L. Ferris, M. Karamouzis, R.S. Andrade, E.L. Deeb, S. Burton et al., Stereotactic body radiotherapy for recurrent squamous cell carcinoma of the head and neck: results of a phase I dose-escalation trial. Int. J. Radiat. Oncol. Biol. Phys. 75, 1493–1500 (2009). doi:10.1016/j.ijrobp.2008.12.075

    Article  Google Scholar 

  49. K.-W. Roh, J.-S. Jang, M.-S. Kim, D.-I. Sun, B.-S. Kim, S.-L. Jung et al., Fractionated stereotactic radiotherapy as reirradiation for locally recurrent head and neck cancer. Int. J. Radiat. Oncol. Biol. Phys. 74, 1348–1355 (2009). doi:10.1016/j.ijrobp.2008.10.013

    Article  Google Scholar 

  50. K.R. Unger, C.E. Lominska, J.F. Deeken, B.J. Davidson, K.A. Newkirk, G.J. Gagnon et al., Fractionated stereotactic radiosurgery for reirradiation of head-and-neck cancer. Int. J. Radiat. Oncol. Biol. Phys. 77, 1411–1419 (2010). doi:10.1016/j.ijrobp.2009.06.070

    Article  Google Scholar 

  51. N. Kodani, H. Yamazaki, T. Tsubokura, H. Shiomi, K. Kobayashi, T. Nishimura et al., Stereotactic body radiation therapy for head and neck tumor: disease control and morbidity outcomes. J. Radiat. Res. (Tokyo) 52, 24–31 (2011)

    Article  Google Scholar 

  52. B. Comet, A. Kramar, M. Faivre-Pierret, S. Dewas, B. Coche-Dequeant, M. Degardin et al., Salvage stereotactic reirradiation with or without cetuximab for locally recurrent head-and-neck cancer: a feasibility study. Int. J. Radiat. Oncol. Biol. Phys. 84, 203–209 (2012). doi:10.1016/j.ijrobp.2011.11.054

    Article  Google Scholar 

  53. E.F. Lartigau, E. Tresch, J. Thariat, P. Graff, B. Coche-Dequeant, K. Benezery et al., Multi institutional phase II study of concomitant stereotactic reirradiation and cetuximab for recurrent head and neck cancer. Radiother. Oncol. J. Eur. Soc. Ther. Radiol. Oncol. 109, 281–285 (2013). doi:10.1016/j.radonc.2013.08.012

    Article  Google Scholar 

  54. S. Dewas, J.E. Bibault, X. Mirabel, P. Nickers, B. Castelain, T. Lacornerie et al., Robotic image-guided reirradiation of lateral pelvic recurrences: preliminary results. Radiat. Oncol. Lond. Engl. 6, 77 (2011). doi:10.1186/1748-717X-6-77

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Academic Radiation Oncology Department, Centre Oscar Lambret & University, Lille II 3 rue Fréderic Combemale, 59000, Lille, France

    Raphaëlle Mouttet-Audouard, Thomas Lacornerie & Eric Lartigau

Authors
  1. Raphaëlle Mouttet-Audouard
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas Lacornerie
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eric Lartigau
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eric Lartigau .

Editor information

Editors and Affiliations

  1. Sezione "Adriano Gozzini", Istituto Nazionale di Ottica, Pisa, Italy

    Antonio Giulietti

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Mouttet-Audouard, R., Lacornerie, T., Lartigau, E. (2016). Cyberknife, Dose Fractioning for Clinical Protocols. In: Giulietti, A. (eds) Laser-Driven Particle Acceleration Towards Radiobiology and Medicine. Biological and Medical Physics, Biomedical Engineering. Springer, Cham. https://doi.org/10.1007/978-3-319-31563-8_3

Download citation

Publish with us

Policies and ethics

Search

Navigation