CyberKnife therapy of 24 multiple brain metastases from lung cancer

CyberKnife therapy of 24 multiple brain metastases from lung cancer

Brain metastases from systemic cancer are the most common type of intracranial neoplasm in adults, being almost 10 times more common than primary malignant brain tumors, which cause a significant burden on the management of patients with advanced cancer (1). The lungs represent one of the most frequent sources of metastases to the brain, with a probability of (36–64%) (3). Symptoms suffered by the patients include headaches, epilepsy, focal weakness, numbness or changes in mental status. The prognosis of patients with brain metastases is not optimistic and the median survival time is ∼1–2 months if left untreated. The 1-year survival rate has been recorded as 10.4% (4,5). The treatment of metastatic brain tumors is complex; not only due to being able to provide local control and improve neurological function, but also due to factors such as age, performance and systemic disease status and the size, volume, location and number of metastases at presentation

CyberKnife is a robotic radiosurgery system with a linear particle accelerator (linac), which is coupled with real-time imaging to track and compensate for the patient’s or target’s motion. As a relatively non-invasive treatment modality, CyberKnife demonstrates certain benefits, including a more accurate target localization and improved dose delivery for the management of metastatic brain tumors that allows higher biologically effective dose delivery without increased incidence of toxicity.

In the present case, the results for the treatment of multiple brain metastases after CyberKnife surgery with a 7–8 Gy marginal dose was promising. CyberKnife for metastatic brain tumors is an effective and safe method for reducing the marginal dose prescribed for multiple brain metastases and for minimizing the radiation-related neurotoxicities. In conclusion, CyberKnife, a focused, highly-targeted radiosurgery and fractionated radiotherapy is particularly useful for multiple brain metastases. CyberKnife provides the advantage of the management of local recurrence and a tolerable complication rate. Although the treatment of brain metastases has been performed with CyberKnife, the clinical significance and optimal dose fractionation scheme require further investigation.

Source : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3788854/

To know more about cancer treatment in chennai kindly  write to me at lakshmipriya_b@apollohospitals.com or call 9940675877

CYBERKNIFE TREATMENT IN OVARIAN CARCINOMA

CYBERKNIFE TREATMENT IN OVARIAN CARCINOMA

A 60-year-old female with a history of Stage IV ovarian carcinoma presented with rising CA-125 levels (21.1 U/ml to 34.4 U/ml), signifying a probable ovarian carcinoma recurrence. Subsequent MRI showed a 2.8 x 2.5 cm nodule in the region of the left upper vaginal cuff which was confirmed by bimanual examination. Initial diagnosis of Stage IV ovarian carcinoma was made six years earlier when the patient presented with right-sided pleural effusion and CA-125 of 1482 U/ml. An exploratory laparotomy was done and an omental cake, peritoneal studding and a nodule adjacent to the rectosigmoid were resected. Pathology showed poorly differentiated serous papillary ovarian carcinoma.

Over the next four years the patient underwent multiple rounds of chemotherapy as well as stem cell transplant and additional surgical resection in the effort to control her disease. The patient’s latest chemotherapy was prematurely discontinued when she experienced a severe anaphylactoid reaction. At that time the decision was made to follow her closely with imaging and CA-125 measurements.

CyberKnife® Treatment Rationale

 Epithelial ovarian cancer is the leading cause of death among women. More than 70% of women with epithelial ovarian cancer have Stage III or IV disease at the time of diagnosis

1 Adjuvant chemotherapy is recommended for all patients with advanced stage ovarian cancer after appropriate surgery. However, more than 70% of patients relapse, with a median time to progression of less than 2 years.

2 Secondary surgery for recurrent patients has not significantly improved survival. Radiation therapy has improved survival in a subset of patients with chemotherapy-refractory disease, particularly those patients with minimal residual or relapsed disease to the pelvis, and has provided good palliation in patients with local abdominopelvic symptoms.

3 This patient presented with a recurrent ovarian cancer in the left vaginal cuff. Due to the patient’s medical history, she was not a candidate for further chemotherapy or surgery. Nevertheless, the left vaginal cuff recurrence was and had always been the only site of recurrence in this patient, therefore aggressive definitive care was indicated.

The use of stereotactic body radiotherapy as an alternative to brachytherapy for gynecologic tumors has been reported to achieve excellent local control rates with minimal toxicities.

4 offered a minimally invasive method for delivering hypofractionated radiation to the left vaginal cuff of a patient who had failed two surgical resections and numerous cycles of chemotherapy.

Source : http://www.cyberknifetampabay.org/

To know more aboutcancer treatment at Apollo speciality hospital  kindly write to me at lakshmipriya_b@apollohospitals.com or call 9940675877

CyberKnife - Hemicranial Meningioma

Successful CyberKnife Irradiation of 1000 cc Hemicranial Meningioma: 6-year Follow-up

Meningiomas are common benign tumors with accepted treatment approaches and usually don't challenge healthcare specialists. We present a case of a huge unresectable hemicranial meningioma, which was successfully treated with hypofractionated irradiation.

A male patient, sixty-two years of age, suffered for over 12 years from headaches, facial deformity, right eye displacement, right eye movement restriction, right-sided ptosis, and facial hypoesthesia. MRI and CT studies revealed an extended hemicranial meningioma. Prior to irradiation, the patient underwent four operations. Eventually, the tumor was irradiated with the CyberKnife in August 2009. Tumor volume composed 1085 cc. The mean dose of 35.3 Gy was delivered in 7 fractions (31.5 Gy at 72% isodose line comprising 95% of tumor volume). The patient was followed during six years and experienced only mild (Grade 1-2 CTCAE) acute skin and mucosa reactions. During the follow-up period, we observed target volume shrinkage for 17% (for 26% after excluding hyperostosis) and regression of intracranial hypertension signs.

Due to the extreme volume and complex shape of the tumor, spreading along the surface of the hemisphere as well as an optic nerve involvement, the case presented would not be generally considered suitable for irradiation, especially for hypofractionation. 

We regard this clinical situation not as a treatment recommendation, but as a demonstration of the underestimated possibilities of hypofractionation regimen and CyberKnife system, both of which are limited with our habit of conventional treatments.

Source : Scoop it

To know more about cyberknife kindly blog your comments or you can write to me at lakshmipriya_b@apollohospitals.com or call 9940675877

BRAIN METASTASIS

In many patients with brain metastases, the primary therapeutic aim is symptom palliation and maintenance of neurologic function, but in a subgroup, long-term survival is possible. Local control in the brain, and absent or controlled extracranial sites of disease are prerequisites for favorable survival. 

Stereotactic radiosurgery (SRS) is a focal, highly precise treatment option with a long track record. Its clinical development and implementation by several pioneering institutions eventually rendered possible cooperative group randomized trials. A systematic review of those studies and other landmark studies was undertaken. 

Most clinicians are aware of the potential benefits of SRS such as a short treatment time, a high probability of treated-lesion control and, when adhering to typical dose/volume recommendations, a low normal tissue complication probability. 

However, SRS as sole first-line treatment carries a risk of failure in non-treated brain regions, which has resulted in controversy around when to add whole-brain radiotherapy (WBRT). SRS might also be prescribed as salvage treatment in patients relapsing despite previous SRS and/or WBRT. An optimal balance between intracranial control and side effects requires continued research efforts.

To know more about cyberknife kindly blog your comments or you can write to me at lakshmipriya_b@apollohospitals.com or call 9940675877

Klatskin tumour

A fifty-four years old Marwari patient from Assam presented with progressive jaundice and intermittent episodes of abdominal pain for three months. CT scan of abdomen showed a small (1.5 x 1.5 cm) mass in the bifurcation of common bile duct which is causing biliary tract obstruction and hence jaundice. Portal nodes were not enlarged and there was no lesion in the liver parenchyma. At presentation, serum bilirubin level was high (14.7 mg/dl). Endoscopic biopsy and brushing cytology was adenocarcinoma and clinic-radiological diagnosis was ‘Klatskin tumour’. 

Metallic stenting was done to relieve jaundice and after stenting serum bilirubin level came down rapidly. PET scan showed increased uptake in the biliary duct region mass without any sign of metastasis. He was evaluated and planned for treatment with robotic radiosurgery. He was treated using robotic radiosurgery (CyberKnife) with high precision radiotherapy technique after fiducial placement (gold seeds) near the tumour. After one year, the patient had no obvious complain, liver function (no jaundice) was normal and CT scan evaluation showed completed resolution of the mass.  

Klatskin tumour is an uncommon tumour that arises from the bifurcation of common bile duct in the abdomen (duct that drains bile from liver). Patients usually present with progressive (increasing) persistent jaundice followed by pain in the upper abdomen. Surgical excision is the mainstay of treatment. However, surgery is not possible in majority of the patients owing to the location of the tumour, high jaundice and medical condition. Chemotherapy may not be an optimal option in majority of the patients as they present with high jaundice. Majority of such patients with poor medical condition are treated with only supportive care and prognosis is dismal (survival for a few months only).

Patients with metallic stent have relief from jaundice but unfortunately in a few weeks time, the stent gets blocked with tumour growth. Patients again present with high jaundice and have severely impaired quality of life. They complain of severe itching of entire body, loss of appetite and succumb due to impaired liver function from high jaundice/obstruction. The treatment is to have a longer ‘jaundice-free period’ which in turn improves quality of life and possibly survival function as well.  

Stereotactic body radiation therapy’s high dose radiation ‘sterilizes’ the metallic stent and bile duct region. It is assumed that with radiation therapy, blockage of bile duct and stent is delayed and patients have longer jaundice-free period.In Klatskin tumour, CyberKnife allows to deliver high dose of radiation in a short duration to the target without significant morbidity. 

Article by Dr.Debnarayan Dutta

To know more about cyberknife kindly blog your comments or you can write to me at lakshmipriya_b@apollohospitals.com or call 9940675877

Renal cell carcinoma

Patients with metastatic renal cell carcinoma (RCC) to the brain have a very poor prognosis of three months if left untreated. SRS is an effective treatment modality in numerous patients. This case exemplifies the utility of stereotactic radiosurgery (SRS) in prolonging survival and maintaining quality of life in a patient with RCC. This 64-year-old female patient initially presented to her primary care physician 22 months after a left nephrectomy for RCC with complaints of mild, intermittent headaches and difficulty with balance. An MRI revealed five cerebellar lesions suspicious for intracranial metastasis. The patient's first GKRS treatment targeted four lesions with 22 Gy at the 50% isodose line. She underwent a total of seven GKRS treatments over the next 60 months for recurrent metastases to the brain. 72 months and 12 months have now passed since her brain metastases were first discovered and since her last GKRS treatment, respectively, and this woman is alive with considerable quality of life and no evidence of metastatic reoccurrence. This case shows that repeated GKRS treatments, with minimal surgical intervention, can effectively treat multiple intracranial lesions in select patients, prolonging survival and avoiding iatrogenic neurocognitive decline while maintaining a high quality of life.

To know more about cyberknife kindly blog your comments or you can write to me at lakshmipriya_b@apollohospitals.com or call 9940675877

choroidal haemangioma (eye lesion)

Master ShreeVaishnav – Kerala, India 
Radiation therapy is one of the most important tools to combat cancer. However, conventional radiation therapy is long course (usually 6 to 7 weeks) treatment and may have severe acute side effects including skin and mucosal reactions, diarrhea, feeding difficulties and others. Higher dose radiation is also not possible to deliver due to limitations related to toxicities. CyberKnife is a precise radiation therapy technique by which high dose radiation therapy can be delivered only to the tumor and minimal dose to the normal structures. CyberKnife treatment is a short course treatment (usually only one to 5 days) and have no or minimal side effects. Many tumors which are ‘resistant’ to conventional radiation are ‘sensitive’ to high dose radiation delivered by CyberKnife. “CyberKnife has unique system that it can track moving tumors and treat them with immaculate accuracy”. Tumors in moving organs such as lung and liver can be treated most effectively CyberKnife. Dr Debnarayan Dutta, Consultant in Radiation Oncology at Apollo Speciality Hospital, Chennai commented “there are few tumors which were thought to be not treatable are now being treated successfully with CyberKnife”.

Master ShreeVaishnav, a 6 year old boy from Kerala suffering with choroidal haemangioma (eye lesion) had vision loss in both the eyes, he was referred from Sankar Netralaya for treatment. He was treated with CyberKnife and at 2 months follow up evaluation his vision had dramatically improved. “We are thankful to Dr Dutta for giving vision back to my son” told ShreeVaishnav’s father who was elated about CyberKnife. “CyberKnife has opened a modern and effective option for these diseases and we are happy with the result” said Dr Prativa Mishra, eye specialist involved in ShreeVaishnav’s treatment.

CyberKnife is a revolution in cancer treatment; it provides effective, short course, minimal toxic and high dose treatment in brain, lung, liver, pancreas, prostate, head and neck and many other tumors.

To know more about cyberknife kindly blog your comments or you can write to me atlakshmipriya_b@apollohospitals.com or call 9940675877

PROSTATE CANCER - TREATMENT THROUGH CYBERKNIFE

Recent studies have reported results of more than 1,000 patients treated with CyberKnife for prostate cancer, with follow-up up to eight years, which has shown that CyberKnife is very effective at treating localized prostate cancer.

Twenty-one CyberKnife centers in the United States have conducted a trial in which patients with early prostate cancer received five treatments of accelerated hypofractionated treatment the same way the Stanford researchers treated their initial patients. To date, more than 320 patients have taken part in this study. (Forty-two patients are from BIDMC's Keith C. Field CyberKnife Center.)

Results concerning the first 250 patients have been reported; the rate of minor side effects was low, acceptable and similar to what is observed with external beam radiation. Cancer control rates also have been excellent.

Based on these results, most (but not all) insurance compaines cover CyberKnife treatment for prostate cancer. Before you proceed with treatment, ask BIDMC for help determining whether your insurer is one of them.

Many patients with early-stage prostate cancer are candidates for CyberKnife therapy.

To know more about cyberknife kindly blog your comments or you can write to me at lakshmipriya_b@apollohospitals.com or call 9940675877

Cyberknife success - Retroperitoneal fibromatosis - biliary obstruction.

Retroperitoneal fibromatosis - biliary obstruction.

A 33 year old lady was evaluated and diagnosed to have a retroperitoneal fibromatosis.

She underwent surgery and post operative radiotherapy . She was on follow up. She delivered a baby boy after a couple of years. 4 months after delivery, she was evaluated for weight loss and poor appetite. She was found to  have biliary obstruction .

Pet ct showed a small recurrent mass causing the obstruction. She was re irradiated with cyber knife radio surgery.

Follow up pet ct showed regression in the size and activity of the mass  This patient benefited of this treatment modality without major surgery. She is doing well and enjoying with her baby

This is a case study discussion of Dr.Rathna who is a senior consultant , Radiation Oncology, Apollo Speciality Hospital, Chennai.

To know more about cyberknife kindly blog your comments or you can write to me at lakshmipriya_b@apollohospitals.com/9940675877

Back pain due to aortacaval mass - Success with Cyberknife.

Colon Carcinoma - Back pain due to aortacaval mass

A 49 year old man , a known case of carcinoma colon post op, post chemo( in August 2013) was evaluated for back ache. He was operated upon for spondylolisthesis in November 2013.

He had no relief of symptoms. A pet ct done in March 2014 showed an aortocaval mass. There was no lesion elsewhere in the body. He was treated with cyber knife radio surgery. He started having pain relief during treatment  and a substantial relief during follow up.

He was followed up by medical oncologist with chemo . 2 months follow up PET Scan revealed no lesion in the region treated with cyberknife radiosurgery

This is a case study discussion of Dr.Rathna who is a senior consultant , Radiation Oncology, Apollo Speciality Hospital, Chennai.

To know more about cyberknife kindly blog your comments or you can write to me at lakshmipriya_b@apollohospitals.com/9940675877

Success with Cyber Knife - Hepato Cellular Carcinoma

Hapato Cellular Carcinoma- Successful treatment with Cyberknife 

A 60 yr old gentleman was incidentally found to have a space occupying lesion in the liver  which was diagnosed as hepatocellular carcinoma in June 2013.

He underwent a resection of the lesion in July 2013.Follow up imaging showed a small residual lesion and hence he was started on Tab.Sorafinib from November,2013. But serial imaging showed
an increase in the size of the lesion. Biopsy of the lesion confirmed it to be hepatocellular carcinoma.

The various treatment options were discussed. The patient was not keen for surgery and due to the
proximity of the hepatic vein, RFA was also difficult. It was decided to give radio surgery with Cyber knife to the residual lesion. 

After fiducial placement for real time tracking of the lesion, a total dose of 40 Gy was delivered in 5 fractions. He underwent the treatment quite well with no difficulties. Follow up after 2 months imaging
showed a decrease in the size of the lesion with reduced activity of FDG uptake indicating good response to the treatment.

This is a case study discussion of Dr.Rathna who is a senior consultant , Radiation Oncology.

To know more about cyberknife kindly blog your comments or you can write to me at lakshmipriya_b@apollohospitals.com/9940675877

Radiation therapy in modern era of cancer management:

Radiation therapy in modern era of cancer management:

Radiation therapy is being used successfully in cancer treatment for more than a century and is one of the corner stone of success in fight against cancer.  In early days, radium, caecium, radon capsules, which are radioactive materials were inserted in cervix for management of cervical cancer. Dramatic response in these tumours had resulted in interest with radioactive material in cancer management. Initial euphoria regarding the usage of radioactive materials attracted many researchers and there was surge in the indications of it's usage. The potential of gamma rays and x-rays in damaging the tumour cells were used to cancer. With gamma and x-rays, the tumour cell DNA is damaged more than the normal cells, and hence tumour cells are killed where as normal cells are relatively spared. After invent of x-rays, deep x-rays were used to treat tumours. Several x-ray machines were introduced and x-ray was being used to treat almost all diseases including peptic ulcer, ankylosing spondylosis (bone problem), psoriasis (skin problem). However, the progress was halted with evidences of reactions, second malignancies and other toxicities. There was a lull period for few decades in the development of radiation oncology specialty. And, during 1960s and 70s after the discovery of artificial radioactive materials, there was again revival of this specialty with 'tele-cobalt' machines. There was 'simulator' for planning treatment, scientific dose calculation methods, and accurate treatment delivery technology. 'Shields' and 'blocks' were being used to protect normal tissues and deliver higher dose of radiation to the target- 'tumour'. Favourable outcome with this modern radiation therapy gave the required confidence to the clinicians and more and more cancer patients were treated with radiation therapy with success. However, still there was lot of limitations in both treatment delivery and planning. There was no imaging to see the target, no proper computer assisted planning tools and there was visible scope of improvement of treatment delivery technology.

Modern day radiation therapy coincided with the advent of computers, imaging and mechanical revolution and also incorporation of technology in medical science. In 1990s, with advent of computers, CT and MRI scan and most importantly active involvement of technologists in research and development has revolutionized radiation therapy speciality. Modern radiation therapy is one of the 'most sort after' and 'high tech' medical specialty. Computer guided planning enables us to deliver high dose of radiation to the tumour and spare normal tissues. Intensity modulated radiation therapy and Image guided radiation therapy is the advanced radiation therapy delivery technology with most modern techniques. Now, robotic radiosurgery has enabled us to deliver high dose of radiation in very short time and complete radiation therapy in less than one-week time. Side effects of radiation have dramatically reduced and now radiation therapy is more acceptable to the patients. Radiation therapy is the standard of care in early head & neck cancer, cervical cancer and an important component of organ preserving procedures such as breast conservation. After surgery, majority of advanced cancers are treated with radiation therapy. Stereotactic radiosurgery is now the alternative to surgery in deep-seated 'difficult to do surgery' cases. There are numerous randomized studies with level-I evidences showing survival (mainly loco-regional control and also over all survival) benefit of radiation therapy in brain tumours, head & neck cancers, breast cancer, cervical cancer and other cancers.

Radiation therapy is a cost-effective option in management of metastatic diseases and palliative situations such as bone metastasis and brain metastasis. In developing countries like India with resource constraints radiation therapy should be used in most of the clinical situations, especially in palliative and management of pain.

In future, proton beam therapy, intra-operative radiation therapy and shorter course of radiation therapy (fractionated radiosurgery) will be the one of the main ammonium to fight against cancer. However, there are still many challenges in radiation oncology that needs to be addressed.

More than 70% of cancers need radiation therapy at some point of time. In 2020, India will have one of the largest numbers of cancer patients in the world and there will be two times than the present cancer burden. Unfortunately, there are in a severe scarcity of radiation therapy facilities in developing countries like India. At present situation, with available radiation facility in India only 30% of patients who require radiation treatment can avail radiation therapy. Majority of the patients need to travel far from their native place for treatment, only a small proportion of patients who need treatment receive radiation therapy, there is lack of awareness and cost of the treatment (facility) is also an issue. There is a need for more number of cancer facility including radiation therapy machines in different small cities and towns in India.  

The author of this article is Dr.Debnarayan Dutta, consultant, Apollo Speciality Hospital 

For More information feel free to blog your comments or write to lakshmipriya_b@apollohospitals.com or I can be reached @9940675877

1 PINEAL REGION LESION - CYBERKNIFE TREATMENT.

1  PINEAL REGION LESION - CYBERKNIFE TREATMENT.

     This 32 year old lady was evaluated for headache and visual disturbances. She has also had urinary and bowel incontinence. She was found to have a pineal region space occupying lesion with hydrocephalus. She underwent a VP shunt and was referred for radiotherapy. She was initially treated with SRT and cyberknife was used to deliver the additional boost dose with maximal sparing of normal structures in November 2010. She is on follow up. She is asymptomatic and good resolution of the lesion.

The patient was under treatment with Dr.Rathna Devi, senior consultant Radiation Oncologist. 

For More information feel free to blog your comments or write to lakshmipriya_b@apollohospitals.com or I can be reached @9940675877

CAVERNOMA TREATMENT WITH CYBERKNIFE

    

CAVERNOMA TREATMENT WITH CYBERKNIFE    

This 36 year old lady was evaluated for giddiness, vomiting and imbalance while walking. She was found to have a cavernoma in the left cerebellum. She was taken up for cyberknife radiosurgery due to the complications associated with surgery. She was treated with a single fraction radiosurgery as an out patient procedure in July 2012. She is on follow up with marked reduction in the volume of the cavernoma  and symptomatic improvement.

The patient was under treatment with Dr.Rathna Devi, senior consultant Radiation Oncologist. 

For More information feel free to blog your comments or write to lakshmipriya_b@apollohospitals.com or I can be reached @9940675877

CAVERNOMA - VASCULAR MALFORMATIONS _ CYBERKNIFE

     

 A 36 year old man from Kolkata was evaluated for the complaints of double vision and swaying while walking for 2 months. MRI showed a cavernous malformation in the brain stem. He was referred for radiotherapy as the location was eloquent. He was irradiated with fractionated radiosurgery keeping in mind the site of the lesion. 6 months after treatment he came for follow up. His gait was steady, his vision had improved and the MRI showed a dramatic decrease in the size of the lesion.

Vascular malformations of the brain pose threat by their propensity to bleed and cause neurological deficits. The brain stem location of this cavernoma makes surgery an obsolete option. The effective and conformal dose delivery helped in reduction in the volume of the malformation and improvement of symptoms.

Apollo Hospitals has treated more than 1000 cyberknife cases.

The patient was under treatment with Dr.Rathna Devi, senior consultant Radiation Oncologist. 

For More information feel free to blog your comments or write to lakshmipriya_b@apollohospitals.com or I can be reached @9940675877

CYBERKNIFE TREATMENT - ACOUSTIC SCHWANNOMA

      A 47 year old lady from Kolkata was evaluated for decreased hearing in the left ear. MRI revealed an acoustic schwannoma. BERA (audiometry) revealed profound to severe hearing loss on the left side. She came for radiosurgery. She was irradiated with cyberknife radiosurgery technique in January 2013. Six months later she came for follow up. Her hearing had improved and it was confirmed with an Audiometry then. MRI also showed a decrease in the size of the lesion.

Acoustic schwannoma is a benign neoplasm in the eight cranial nerve.  Surgery for these lesions are complicated by the fact that preservation of hearing is a difficulty. Cyberknife radiosurgery delivers adequate dose to control the tumor growth with preservation of hearing.


We have successfully completed more than 1000 cases 

The patient was under treatment with Dr.Rathna Devi, senior consultant Radiation Oncologist. 

For More information feel free to blog your comments or write to lakshmipriya_b@apollohospitals.com or I can be reached @9940675877

CYBERKNIFE TREATMENT FOR TRIGEMINAL NEURALGIA

tA 68 year old gentleman from Kolkata presented to our outpatient facility with complaints of left sided facial pain. He has been on medications for trigeminal neuralgia for the past 24 years with little benefit. He had been on and off medications and had also tried alternative medicine. He was not willing to undergo surgery. He was referred here for radiosurgery. He was irradiated with single fraction radiosurgery by cyberknife in July 2013. Less than two months later has 90% relief of pain.

Trigeminal neuralgia is a condition where the patients experience unbearable pain on one side of the face with major debilitation due to pain. These patients are treated with cyberknife radiosurgery so that a large dose is delivered to 2mm  of the nerve with extreme precision. The adjacent brainstem can be successfully protected with cyberknife radiosurgery and the pain relief starts within a month. 

The patient was under treatment with Dr.Rathna Devi, senior consultant Radiation Oncologist. 

For More information feel free to blog your comments or write to lakshmipriya_b@apollohospitals.com or I can be reached @9940675877

A CASE OF CARCINOMA PROSTATE.

 CARCINOMA PROSTATE.

This 65 year old gentleman was found to have an elevated PSA 18 ng/dl, on evaluation , found to have adenocarcinoma prostate (Gleason 3+4). He was treated with a combination of IMRT and Cyberknife. This enabled the delivery of the required dose to the prostate. Follow up PSA was 4 ng/dl and dropped to 1ng/dl during the second follow up. 

 The patient was under treatment with Dr.Rathna Devi, Senior consultant Radiation oncology.

Please feel free to blog back your comments or for other queries please write to lakshmipriya_b@apollohospitals.com, or you can reach me @9940675877

A CASE OF PITUITARY MACROADENOMA.

PITUITARY MACROADENOMA.

This 54 year old lady was evaluated for weight gain and skin pigmentation. She was found to have a pituitary adenoma. She underwent a transphenoidal surgery.  One and a half months later she became symptomatic. She was treated with Cyberknife for the residual lesion. When she came for follow up, she was symptomatically better and the follow up imaging showed a marked reduction in the size of the lesion. 

The patient was under treatment with Dr.Rathna Devi, Senior consultant Radiation oncology.

Please feel free to blog back your comments or for other queries please write to lakshmipriya_b@apollohospitals.com, or you can reach me @9940675877

A CASE OF LUNG CANCER WITH BRAIN METASTASES.

LUNG CANCER WITH BRAIN METASTASES.

This  44 year old lady presented with mass in the lung. She was evaluated and was found to have three metastatic lesions in the brain. She had a well preserved general condition. The lung lesion and the brain lesions were treated with Cyber Knife. She had a good response. Even after one year she is in good health and is on follow up.  

The patient was under treatment with Dr.Rathna Devi, Senior consultant Radiation oncology.

Please feel free to blog back your comments or for other queries please write to lakshmipriya_b@apollohospitals.com, or you can reach me @9940675877