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CyberKnife Effectively Treats Brain Tumors without Surgery– Dr Aditya Gupta, Director,Neurology, Agrim institute for neuro sciences, Artemis Hospital

Indu, a young 32-year old housewife noticed whistling sounds in her left ear 1 year before she consulted her physician in Agra. One thing led to another, and an MRI scan of her brainshowed a benign tumor involving her hearing nerve, an Acoustic Neuroma. The gradual growth of the tumor in the main nerve leading from the inner ear to the brain started causing balance and hearing complications.

But the symptoms being mild in the beginning, she thought it to be some kind of weakness and ignored it. Later due to the pressure build up by the tumor started causing whistling sound in her left ear and led to unsteadiness. Her neurosurgeon advised her to undergo open surgery. Being confused and worried with the doctors’ statement she wanted to wait for sometime as she was not mentally prepared for the surgery. This delay led the tumor to grow further affecting the adjacent nerves that control facial muscles and other vital brain functions.

With constant dizziness and hearing problem she was then airlifted to Artemis Hospital Gurugram, where immediate attention was given to reveal that the complication had worsened.  MRI revealed that the tumor had grown large enough to compress the brain stem and the condition now was life threatening due to fluid build-up in her skull.

The team decided to use M6 cyberknife, which is a non-invasive radiosurgery technique. And within half an hour the lady was completely treated without any risks or complications. She was discharged the same day and went back home to her normal daily activities. There were no risks, scars, no pain, no ICU stay or a week stay in the hospital, and no anxious husband waiting outside the operating room. Now, her MRI scans done later have shown us that this treatment was a cure, and her hearing remains the same.

The above case shows that CyberKnife radiosurgery system used as an alternative to surgery, or in conjunction with other treatments plays a significant role in the management both non-cancerous and cancerous brain tumors.

The technique that has been around in India for about 3-4 years has been mostly used to treat a range of cancerous and non cancerous/benign tumors in the body including the prostate, lung, liver, etc., is now being commonly used to kill tumors of brain and spine as well.

What is CyberKnife?

Basically, CyberKnife radiation surgery is the most advanced, non invasive radiation therapy tools available to treat especially non-cancerous as well as cancerous and other diseases with the help of precise beams of high-dose radiation. It is a no pain and a no risk day-care treatment wherein patients are discharged as soon as the session gets over and therefore, no hospitalisation is required. The treatment uses a sophisticated image guidance system to beam high doses of radiation directly to your tumor.

The CyberKnife radiation therapy has clinically proven success rates, however, it works the best for a tumors that’s upto 2-2.5 cm in size. However, in a few rare cases it is also used as an treatment option to cure brain tumors that either cannot be operated because of their location in the head, or the patients who cannot undergo brain cancer surgery due to their poor medical condition, etc.

The next generation of CyberKnife – M6 is highly precise when compared to the earlier ones used in India as this offers some of the exceptional features and delivers a maximum dose of radiation directly to the tumor from many different angles with sub-millimeter precision for the higher success rates. Also, the emitted focused beams of intense energy destroy cancercells and shrink/control the growth of tumors. It further prevents the cancerous cells from multiplying. Infact, the objective of radiation therapy is to destroy the harmful cells while minimising damage to healthy cells.

Besides, the CyberKnife system automatically adjusts itself and tracks the tumor which aids in minimising radiation exposure to healthy organs and tissues. The CyberKnife radiation surgery offers multiple benefits compared to conventional radiation treatments and surgery.

Cyber Knife Vs conventional Gamma Knife 

For brain tumor or cancer patients, Gamma Knife treatment is not as convenient or comfortable, largely because Gamma Knife requires an invasive head frame be bolted into the skull. Compared to this, the CyberKnife is a non-invasive, real-time motion tracking technology for accurate delivery of high-dose radiation therapy. Instead of a bulky head frame, CyberKnife patients are provided with a soft, mesh mask during the treatment.

Moreover, treatment with CyberKnife is flexible; imaging is performed few days in advance, thereby leaving the radiation oncologist with enough time to design and finalise a customised treatment plan. Once the plan is set in place, the patient will return for a non-invasive, pain-free experience. Using advanced tumor-tracking technology, the CyberKnife system is able to either deliver one single high-dose treatment, or smaller doses (upto 5) over the course of two to five days. This approach limits side effects and enables most patients to return to their regular routine the same day. Additionally, clinical studies have shown that patients with certain cancerous and non-cancerous conditions in the brain, neck and spine have a better outcome with a lower dose of two to five fractionated radiation treatments than a single, large dose.

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