CyberKnife for Lung Cancer

“The results in treating lung cancers with CyberKnife® have been extremely encouraging. We are able to treat patients who have other complicating conditions, such as advanced COPD or heart disease that would make them otherwise inoperable. We are able to give very high doses of radiation in just a few days without damaging surrounding tissues.” 

- John Thayer, M.D.
Cardiothoracic Surgeon, Saint Francis Hospital and Medical Center

Surgical resection is the treatment of choice for early stage lung cancer. But, many patients are unable to undergo surgery, for a variety of reasons. Until recently, conventional radiation delivered in daily treatments over six to seven weeks was the next best alternative. Lung cancer can be challenging to treat with conventional radiation because tumors in the lungs move as you breathe. This natural movement makes it difficult to focus radiation on the tumor, and exposes surrounding healthy tissue to unnecessary doses of lung cancerradiation. As a result, the success rate of conventional radiation for lung cancer is modest at best, and the high doses delivered to surrounding organs and tissues can sometimes result in significant side effects.

Stereotactic Body Radiation Therapy (SBRT), which can be performed by the CyberKnife®, has become the preferred method of treatment for patients who have early stage lung cancer and are ineligible for surgery. The CyberKnife, with its ability to constantly track and target a lung tumor as it moves with breathing, can precisely deliver obliterating focused radiation in just three to four treatments over the course of one week. Many studies have demonstrated success rates of 80 to over 90% for CyberKnife and SBRT in the treatment of early stage lung cancer.

CyberKnife avoids the problem of tumors moving with breathing, while effectively controlling or destroying lung cancer cells. With an advanced combination of computer and imaging technology, CyberKnife identifies the exact location of the lung tumor. It also coordinates with the Synchrony® Respiratory Tracking System, which follows the tumor’s movement as the patient breathes, to help the CyberKnife accurately focus radiation on the tumor without affecting any surrounding healthy tissue. 

Preparing for CyberKnife Treatment

Your team of trained specialists at Saint Francis will help you understand every step of CyberKnife treatment.

Before you have CyberKnife treatment, you may need:

  • Fiducials – Fiducials are tiny gold seeds that guide the CyberKnife tools to the exact location of your tumor. Currently about half of our patients can be treated without fiducials, depending on the size and location of the tumor. If your doctor determines that you will need fiducials for your CyberKnife treatment, about three to five rice-sized fiducials will be implanted into your tumor during an outpatient procedure in preparation for your CyberKnife treatment.
  • Some of our lung cancer patients can now be treated without fiducials. This is because of a recent upgrade to our CyberKnife that allows the system to accurately target the cancer without requiring fiducials.
  • If fiducials are required, they are placed in one of two ways: through a bronchoscope, or using needles, guided by CT scans.
  • With either method, you should be able to return home within an hour or two following the procedure.
  • Placement of CT-guided lung fiducials may result in a complication known as a pneumothorax (sometimes referred to as a “collapsed lung”). This complication occurs in about one-third of lung fiducial patients. If a pneumothorax occurs, it may be minor, requiring no further treatment, or on rare occasions may require a chest tube to re-expand the lung. This procedure may result in admission to the hospital overnight.
  • Do not eat or drink 8 hours before the fiducial placement procedure. You may take your normal medications that morning with a small sip of water.
  • Because patients may receive intravenous sedation, arrangements should be made to have someone drive you home that day.
  • Custom body mold – This mold is formed to your body to lie on, and will help you feel more comfortable during any pre-treatment imaging procedures, as well as during the CyberKnife procedure itself. It also keeps your body from moving too much so that all procedures will be as precise as possible.
  • Synchrony vest – This comfortable vest works along with the Synchrony Respiratory Tracking System. It contains light-emitting diodes which allow the CyberKnife technology to follow the position of your tumor even as you breathe. This helps make sure that only your tumor receives radiation beams, and not any surrounding healthy tissue.
  • Imaging – You will need to have a computed tomography (CT) scan, which creates a detailed picture of your tumor using computers and x-rays. The CT scan will give the CyberKnife the information it needs to pinpoint the exact size, shape and location of your tumor.

During CyberKnife Treatment

  • Cyberknife lungBefore each treatment, our team will help you put on your custom body mold and Synchrony vest. During the treatment, you should lie still on the table and breathe normally. The CyberKnife robot will move around your body delivering radiation beams to your tumor.
  • You should not feel any discomfort, and nothing will touch you directly.
  • During the treatment you can even watch a movie on the flat screen TV on the ceiling! Treatments typically take 1-2 hours.
  • You are generally free to return to your regular schedule following the procedure.

After CyberKnife Treatment

  • Most lung cancer patients will receive three to four CyberKnife treatments over the course of one week.
  • After treatment, you should be able to return to your normal daily activities.
  • Many patients experience no side effects. During the first few weeks following CyberKnife, some patients may experience fatigue. Less common side effects include mild cough, shortness of breath or difficulty swallowing.
  • If you are concerned about any symptoms you may experience, contact your CyberKnife physician or nurse.
  • Patients are seen in follow-up evaluation 4-6 weeks after treatment, then every 3-6 months afterwards. Often, CT or PET scans may be ordered to evaluate the response to the CyberKnife treatment. Many cancers will continue to show continued response for up to 3-6 months after treatment.