CYBERKNIFE IN TREATMENT OF ACOUSTIC NEUROMAS

CYBERKNIFE IN TREATMENT OF ACOUSTIC NEUROMAS

Dr.Sanjay Chandrasekhar – Senior Consultant Radiation Oncology


Acoustic Neuromas have always been considered ideal targets for radiosurgery.
These tumors generally cause diminished hearing or loss of hearing, giddiness or dizziness, loss of equilibrium or balance and facial nerve paralysis.

Traditionally these tumors have been treated either surgically or with radiation. Surgical removal of these tumors has been associated occasionally with injury to the facial nerve.

Either conventional radiotherapy, Stereotactic radio therapy or single fraction Gamma knife or X-knife radio surgery have been used for patients with Acoustic Neuromas depending on size, symptoms at presentation, cost factor etc.,

Small Acoustic Neuromas are considered ideal targets for stereotactic radiosurgery. Large series of such patients treated with either Gamma Knife or X-knife have been published. The earlier experience with Gamma knife or X- Knife in treating these tumors with a single fraction radio surgery had yielded reasonably good responses and long term tumor control rates.

The incidence of facial nerve injury and diminution of hearing in a sizeable number of patients while using single high dose radio surgery prompted investigators to explore the possibility of using fractionated radio surgery of Acoustic Neuromas.

Fractionated radio surgery has evolved recently with the increased use of the CyberKnife as a potent tool in the management of these benign tumors. The frameless feature of the cyberknife has resulted in bettering patient compliance and comfort. The entire treatment is completed over 3-5 days on an outpatient basis. In addition, the entire treatment is robotically guided increasing the accuracy to a sub millimeter level.

The cyberknife experts worldwide are convinced about the efficacy and safety of the use of fractionated Cyberknife radiosurgery in the treatment of Acosutic Neuromas. The long term tumor control rates and hearing preservation rates have been extremely satisfactory according to them(University of Stanford experience).

You can also read a success story through the following link : accuray.com/uploadedFiles/Suzanne_Patient_Story.pdf

Cyberknife Experience - Patient Profiles

Patient Profile: Mr. C.V.G

Mr. C.V.G is a senior gentleman aged 86 years with a sharp mind with shining eyes. He was diagnosed with cancer of the prostate in 1999. He underwent TURP plus Bilateral Orchidectomy and was on hormonal management. A second cancer was detected three years later. This time a much more aggressive tumour in the nasal area. Conventional radiotherapy was able to control the disease for a year. But the nasal tumour kept on coming back. Laser surgery could remove only part of the tumour so it kept on re-growing. Chemotherapy was not considered for him being above 80 at that time. By the end of 2008 patient was having a completely blocked nose with epistaxis and permanent discharge. He was unable to breath properly anymore. His eyes were not shining anymore. Another course of radiotherapy to this area with eyes in close vicinity did not come to the picture, and hence Cyberknife was the only treatment option. We completed the procedure April 2009. Few weeks later, Mr. CVG returned smiling and had an opened up nasal cavity and with no complaints. Even the radiation oncologists were surprised by the fact that this radiation has targeted the inside tumour almost exclusively. Though it was a second irradiation there was hardly any radio-reaction on the skin. He thinks of visiting his son in the US again …

Patient Profile: Mr. JT

A young man aged 17 years was diagnosed with Hypothalamic Hamartoma
This young man had a long history of Gelastic seizures. The cause for this was a large space-occupying lesion in the suprasellar region. He underwent surgery but the tumour could not be removed as it appeared very vascular and per-operatively there was a lot of bleeding.
The only option for him was stereotactic radiosurgery. The CyberKnife treatment was done for him over 5 sittings in one week. He did not experience any side effects either during
or after the treatment. In fact, he used to travel all the way from Kovalam daily for this treatment. It has been over 2 months following therapy, he is doing fine and his symptoms have reduced. Since this tumour responds slowly to radiation, a post treatment scan has been scheduled for one month from now.

Patients from Asia, Middle East & Africa benefit from the Apollo CyberKnife Treatment

• A new ray of hope. An innovation in the treatment of cancer
• Apollo Speciality Cancer Hospital is the first hospital in India to treat patients with the revolutionary CyberKnife.
• Since the recent clinical inauguration, over fifty patients have undergone treatment and the results are very promising

Chennai, June 17, 2009: With the launch of Asia Pacific’s most advanced and India’s first CyberKnife^®, Apollo Speciality Cancer Hospital has joined the global league of hospitals equipped to provide 360-degree cancer care. Since the recent clinical inauguration by Prof. Dr. John Adler, the father of the CyberKnife, the hospital has reviewed around 600 cases and over 50 patients have already benefited from the treatment.

Addressing the media, Dr. Janos Stumpf DMS, Director Research in Oncology, representing the Apollo Cyberknife Clinical Panel said, “Over fifty patients with Intracranial, Spine, Lung and Prostate Tumors have benefited from the Apollo CyberKnife treatment and the results are very promising. Many of the patients had tumours that would have been considered inoperable or even untreatable earlier. The CyberKnife treatment offered them a new ray of hope. In quite a few cases, the CyberKnife treatment was even preferred to avoid the risks associated with conventional surgery. Apollo Speciality Cancer Hospital has received patients from across the country, Bangladesh, Malaysia, Oman, Sri Lanka, Iraq, Iran and Pakistan.”

While introducing a few patients present at the media briefing, Dr. Sanjay Chandrasekar, Senior Consultant Radiation Oncology said, “The CyberKnife offers precise, painless and non-invasive radiosurgery treatment. Most patients who undergo the Apollo Cyberknife treatment are free to resume their daily routine almost immediately even after the procedure.”

Benefits to Patients

· A new treatment option: This extraordinary sophisticated treatment can be used as an alternative to open surgery. Occasionally CyberKnife^® treatment can even convert a technically inoperable tumor to operable.

· Pain free: Treatment does not cause pain and therefore does not require anesthesia.

· Recovery Time: Vast majority of CyberKnife^® treatments are out patient procedures allowing patients to continue their activities.

· Comparative comfort: Many of the available high precision radiation techniques require application of some kind of frame around patient’s body, CyberKnife^® can spare that particular inconvenience for the patient. In many of the cases, it is a frameless procedure.

The CyberKnife^® system has significant benefits. Many of the complications associated with other conventional cancer therapies are minimized or eliminated by the CyberKnife^® system. In addition, it is possible to treat multiple tumors at different locations in the body during a single treatment session. Patient normally experiences dramatic pain relief after the CyberKnife^® treatment”.

All patients are reviewed by the Apollo CyberKnife^® Advisory Board prior to a decision on treatment

ACCURAY PRESS RELEASE ON THE FIRST CYBERKNIFE TREATMENT IN INDIA

First Patients Treated in India Using CyberKnife Radiosurgery
Newly Installed System at Apollo Hospital Treats Six and Preps Eight Patients in First Week
SUNNYVALE, Calif., April 3, 2009

To read more .... log on to http://www.accuray.com/; http://www.accuray.com/Content.aspx?id=2406&terms=india

Source: Accuray Inc

Cyberkife In India

Apollo Speciality Hospitals, Chennai has been the first Hospital in India to have started treatment with Cyberknife . We have so far treated 40 patients with Intracranial, Spine, Lung and Prostate tumors and the results are very promising.

For More Information regarding CyberKnife at Apollo please feel free to call Cyberknife Helpline, Ms.Lakshmi @ 044-24334455 or 9941056677 or SMS Apollo at 56677 . Email enquiries can also be to be sent to cyberknife@apollohospitals.com.

You may also visit us at http://www.cyberknifeindia.in/ and http://www.cyberknifeinindia.com/

Cyberknife Resource Team