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CyberKnife Treatment for Lung Cancer at BMC

The Center for Thoracic Oncology is now offering lung cancer patients the option of a new, minimally invasive procedure to fight the disease.

CyberKnife technology uses a technique known as extracranial stereotactic radiosurgery to precisely deliver high doses of radiation using multiple convergent beams. Surgeons use a computer-controlled robotic arm to direct a lightweight linear accelerator to treat the tumor. Lung tumors are tracked using real-time image guidance during treatment, and the robotic arm moves along with the target as the patient breathes.

"The combination of techniques we use dramatically reduces the amount of normal, healthy tissue that receives radiation, lessening the potential for side effects," said Michael Ebright, MD, Former Co-Director, Lung Cancer CyberKnife Program at BMC, and assistant professor of cardiothoracic surgery at Boston University School of Medicine.

Advantages of CyberKnife technology

Surgeons have used similar radiosurgery techniques that use multiple convergent beams to treat patients with brain tumors. Unlike those techniques, which require rigid mental frames that are bolted to the patient's skull, the CyberKnife can be used treat tumors nearly anywhere in the body. Image-guided feedback to the robotic arm makes rigid frames, respiratory gating and breath-holding unnecessary.

Lung cancer patients undergoing treatment with the CyberKnife may require fiducial placement in the vicinity of the tumor using CT-guided percutaneous or bronchoscopic techniques. Others may not require this procedure, and instead may benefit from CyberKnife's fiducial-free X-sight Lung Tracking System, which makes the entire procedure completely non-invasive.

"CyberKnife is especially appealing to patients because it doesn't require general anesthesia," Dr. Ebright said. "It typically requires only three to five treatments, has fewer side effects than conventional radiation therapy, and is painless. We feel the advantages offered by the CyberKnife are of tremendous benefit to our patients."

Matching candidates with the technology

Candidates for treatment with the CyberKnife include patients with early-stage lung cancer  or pulmonary metastases. It should be reserved for those patients who are deemed not to be surgical candidates because of medical co-morbidities, anatomic considerations or surgical refusals.

"CyberKnife is an exciting, new therapy that will allow us to more effectively treat non-surgical patients who, before now, had very limited options," said Dr. Ebright.

Patients being considered for treatment with the CyberKnife are first seen in the Thoracic Oncology Multidisciplinary Clinic, where they are evaluated by Dr. Ebright; Gregory Russo, MD, a member of the Department of Radiation Oncology at BMC; and physicians from other disciplines during a single visit. During this consultation, the team will determine whether the CyberKnife is appropriate for the individual patient.

Pre-treatment planning typically consists of a single dedicated CT scan. Dr. Ebright defines the target lesion and nearby critical structures. Working with a team of physicists, Dr. Russo formulates a treatment plan to accomplish the therapeutic goal. These treatments are delivered by highly trained radiation therapists, who are overseen by Dr. Ebright and Dr. Russo.

The most advanced radiosurgery system in the nation

"At BMC, we are committed to offering state-of-the-art diagnostic and therapeutic modalities for the treatment of lung cancer," Dr. Ebright said. "The CyberKnife system at BMC is the most technologically advanced radiosurgery system in the nation."

To learn more about this treatment option, call Dr. Ebright at 617.638.5600 or visit www.bmc.org/cyberknife. To refer a patient, call 877.930.2288.

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