CYBERKNIFE TREATMENT FOR ACOUSTIC NEUROMAS

CYBERKNIFE TREATMENT FOR ACOUSTIC NEUROMAS

An acoustic Neuroma, sometimes classified as vestibular schwannoma, is a noncancerous tumor which greatly affects the vestibulocochlear cranial nerve. This nerve is responsible for your perception of hearing and stability.

One treatment solution is cyberknife treatment . The reason for this treatment technique is to eliminate the tumor, particularly if it is already large enough to result in total deafness. Furthermore, a significant tumor can also affect and alter the capabilities of other regional organs.

The appearance of cyberknife approach is a less intrusive method for treatment is Cyberknife VSI’s noninvasive surgery for acoustic neuroma. This treatment procedure utilizes gamma radiation to eradicate the developing tumor and leave the site totally free of possibly damaging tumor cells. This type of intervention not simply guards healthy tissues, but produces minimal side effects, and boosts comfort for the patient when focusing on the cancer cells in a precise manner.

With cyberknife VSI’s noninvasive surgery for acoustic neuroma today, the apollo speciality hospital, chennai, India uses up-to-date research, technologically advanced technologies, and has professional physicians to deliver this revolutionary cyberknife treatment method for effective treatment of the acoustic neuroma.

To know more about cyberknife treatment you may blog your comments or write to lakshmipriya_b@apollohospitals.com

CYBERKNIFE IN TREATMENT OF VARIOUS CANCERS

Precision without Incision
One of the UK’s most senior Clinical Oncologists is St Bartholomew's Dr Nick Plowman and he heads this section. In his article 'CyberKnife® – cancer search and destroy’ he explains the use of this powerful new treatment option as both a stand-alone method and in collaboration with other treatments such as chemotherapy.

Then Dr Andrew Gaya, Consultant Clinical Oncologist at Guy’s & St Thomas’ Hospitals NHS Foundation Trust, explains: “Most advances in cancer treatment are small steps forward, but occasionally there is a giant leap.”

CyberKnife® has provided this leap and is now a viable alternative treatment option for:

•Major operations such as lung and liver resections,
•Removal of pancreas and prostatectomy
•Tumours in the body
•Tumours in the brain and spine including brain metastases, primary brain or brainstem tumours, pituitary tumours, acoustic neuromas, meningiomas, arteriovenous malformations and trigeminal neuralgia.

Source : http://www.totalhealth.co.uk/your-condition/cyberknife%C2%AE

To know more about Cyberknife treatment you may blog your comments orwrite to lakshmipriya_b@apollohospitals.com

SUCCESSFUL AVM TREATMENT WITH CYBERKNIFE

SUCEESSFUL TREATMENT OF 19 YEAR OLD WITH AVM USING CYBERKNIFE

CASE HISTORY: This 19 years old college student presented with the complaints of acute onset headache, right hemiparesis and right hemianopia. MRI revealed haemorrhagic infart in left inferior thalamus extending to capsule and old left posterior capsular infart. DSA revealed left temporal AVM (feeder Medial lenticulostride branches of Left MCA draining into vein of galen through basal vein. On examination patient had right hemianopia. Patient underwent treatment with cyber knife radio surgery on 22.6.2009. Patient is on regular follow up with Volume analysis which showed good regression of nidus. January 2011 CT angio revealed complete resolution of AVM. Patient’s vision has dramatically improved.



This 19 year old girl is now 21 years, she is also entering into married life soon. We wish her a very happy married life.

DOCTOR NAME: DR. RATHNA DEVI SR. CONSULTANT RADIATION ONCOLOGIST & CYBERKNIFE SERVICES


For more information you may blog your comments or write to lakshmipriya_b@apollohospitals.com

Glomus Jugulare Tumour successfully treated with cyberknife

MEDICAL REPORT

This 41 years old gentleman a case of glomus jugulare tumour was diagnosed in 2005. He underwent embolisation in 15.03.2005 followed by excision of tumour on 18.03.2005 at Kerala.
On follow up in 5.05.2005 MRI showed residual lesion of size 3.4 x2.2 cm. Patient underwent SRS on 26.07.2005 for a dose of 10 Gy to 80% isodose at elsewhere.
On follow up found recurrence in 2007 for which he went to same center where no further treatment was offered.
Then he went to another hospital in Kerala where he was offered 2nd open surgery for which patient was not willing. Then in April 2010 MRI done showed increase in lesion size about 4.3 cm x 4.21 cm x6.0 cm in size.
TREATMENT

Patient came to Apollo speciality bospital for further treatment. Patient was treated with Cyberknife boost and IMRT after discussion through our tumour board
Now follow MRI revealed good regression of size of tumour and volume analysis showed almost close to 40 to 50 % of reduction in tumour volume.

For more information you may blog your comments or write to lakshmipriya_b@apollohospitals.com

CYBERKNIFE FOR GASTRIC CANCERS

Stereotactic body radiotherapy for isolated para-aortic lymph node recurrence after curative resection in gastric cancer

Metastases from gastric cancer are common and can progress rapidly; even with aggressive treatment 5-year survival rates are low. However, researchers from Korea Institute of Radiological & Medical Sciences hypothesized that there is a certain population of such patients in whom the disease follows a more indolent course, based on studies of patients with
resected liver metastases. This population may benefit from SRS of isolated metastases from
gastric primaries. Thus, they treated 7 such patients with the CyberKnife® System, delivering 45 to 51 Gy (median 48 Gy) in 3 fractions. The patients were followed for 14 to 33 months (median 26 months). Local control was achieved in 6 of 7 patients; 2 patients were disease-free, 3 were alive with disease, and 2 patients died of disease progression. Three-year actuarial overall survival was 43%, and disease-free survival was 29%. The authors conclude that the results support their hypothesis that an indolent subgroup with less aggressive disease progression who could benefit
from the use of local treatments such as CyberKnife Radiosurgery.
 
Source: Accuray's focus newsletter

PROGRESS IN RADIATION ONCOLOGY

PROGRESS IN RADIATION ONCOLOGY

Dr. Janos Stumpf - ADVISOR ONCOLOGY – CYBERKNIFE SERVICES

End of the month November, was an academic feast for the Indian Radiation Oncologists at Hyderabad.

The content of the conference can be summarized in three words: It was about Research, Discipline and Development, especially that of the new machines. It is our pride to realize and say that even latest knowledge about the technical progress has found its way to India, no matter how expensive the machines are. “Precision in Delivery of Radiation” is the mantra for all these technical aspects. Tomotherapy, Cyberknife and Rapid Arc are all the ways to do radio therapy on an extremely precise way.

Cyberknife was covered by two speakers. An eminent guest from California Dr.Nissar Syed was kind enough to give an over-all review about the machine. His talk was followed by the ‘Indian experience’ with Cyberknife based on more than hundred fifty cases treated already at ASH Chennai. Characteristics of the first 150 cases were presented. Apollo has considerable success:- partial remission even in majority of the ‘lost’ cases.

Beside the advantage of saving normal tissue in the brain or extracranially, CK represents a huge leap forward in treating moving targets like cancer in the lung, liver or in the prostate. All these three organs, move during the radiotherapy.



The first patient, Master Shanka had very serious neurological complaints at the time when he came to Apollo. He was attended by Sr. Consultant Neurosurgeon Dr.Balamurugan. However his attempt to remove the haemangioblastoma from the patient’s brainstem was confined to fail due to the dangerously high vascularity which is the nature of that kind of tumors. But this surgical nightmare can be converted into an advantage with the help of High Precision Irradiation (HPI). High vascularity means high density of endothelial cells which are covering the inner surface of the vessels. These vulnerable cells can react with an overgrowth for the exposure of radiation.


Few months after the success full Stereotactic Radiosurgery with CK, part of the tumor has been obliterated its overall size started to come down.This is why the patient has improved and could resume his normal life.

Fate of a patient with inoperable lung cancer is practically known at the time of the diagnosis. Only a very minimal percentage of the inoperable lung cancer cases can be saved by the combination of conventional irradiation with chemotherapy. CK seems to bring a new hope for these patients. A 57 year old gentleman from the neighboring Srilanka successfully conquered one cancer 10 years ago with the help of Apollo Speciality Hospital. He came with hope again when an inoperable lung cancer in his chest was diagnosed. Chemotherapy has failed unfortunately. And then Cyberknife seemed to come for his rescue. High precision and short duration, biologically very intensive radiation has resulted in an impressive remission of his advanced lung cancer without any side effects. This aggressive cancer does have the capacity of invading the rest of the body. As a matter of fact the same has been observed with that particular patient too. But for him this is not the “end of the road”. A second CK treatment is planned to attend all the new sites of cancers shown on the PET CT. Highly sophisticated tools in radiation oncology do allow us to provide longer control with reasonable if not excellent quality of life even in an aggressive cancer.

There is a beautiful sentence told by Rabindranath Tagore about the disease in general. “DEATH DOES NOT HURT US, BUT DISEASE DOES, BECAUSE DISEASE CONSTANTLY REMINDS US OF HEALTH AND YET WITHOLDS IT FROM US.”

This is double true for cancer. Quality of life of a patient has to be one of the primary concerns of an oncologists. Many cancers have a tendency to migrate to the bone, to the spine. These metastatic lesions have the capacity to paralyze the patients by compressing the spinal cord. Chemotherapy frequently has only temporary control over the progress and so does conventional radiotherapy. But high precision in CK helps. We have the technical skill and opportunity to give high precision irradiation to the spine and to arrest this type of tumours even before they cause the extremely bad condition of transverse lesion of the spine. A Professor from George-Towns University in Washington DC said “by now we hardly deal with paralysis due to metastasis to the spine. It is being attended with CK at a curable and controllable stage and the patient will not be confined to bed for the rest of his/her life.


The basic question: ‘How cancer can be tamed in general’ still remains unanswered. But the tremendous progress gives hope for both temporary control with good quality of life and for cure in many cases. It is our job and duty to know about new developments and to apply them with wisdom. This conference was all about this.

Cyber Knife Radio surgery in Pediatric Patients

Cyber Knife Radio surgery in Pediatric Patients

Dr.R.Rathna Devi, Sr. Consultant Radiation Oncologist

“One little girl told me “ I want to go to school” she was one of my early pediatric patient with AVM for the new facility, Cyber Knife. That’s what was on her mind. And that’s what she did. She went to school immediately after her treatment. This made a tremendous difference to the family and to the child, and I was very happy to have offered her this”.



Cyber Knife radio surgery has a great advantage in treatment of pediatric intra and extra cranial lesions which includes non – invasive immobilization, low radiotherapy exposure to the developing normal brain other tissues and ability to fractionate the treatment.

Young patients in the past were usually required to wear a of head frame (Gamma Knife, other kind of radiosurgery equipments), and had to remain anesthetized during the entire, often day long procedure.


These procedures uses rigid metal frame attached directly to the patient’s skull to orient the radiation beams, making it difficult to treat young children with small/ fragile heads. Because the frame cannot be removed between the initial imaging and subsequent treatment, doctors also had to work fast with the other types of radio surgery. With the clock ticking, we had to place the frame, perform CT/MRI or other imaging studies; get everyone involved to meet, plan the treatment and then treat the patient, while the patient is intubated and asleep. This is not an optimal situation.

Fortunately now at Apollo Speciality Hospital we can treat young patients (who can hop off the table and go home or to school) after the initial imaging step while we plan the treatment strategy. The non invasive process uses tiny focused beams of radiation to perform radio surgery on a patients head or body. This technique allows us (Doctors) to attack trouble spots deep within the brain while minimizing the dose of radiation to surrounding healthy tissue. This is particularly important in children, whose brain is still developing.

ADVANTAGE - CYBERKNIFE

Cyberknife which was developed by John Adler, uses a mesh mask to stabilize the head. The technology tracks any unintentional movement on the part of the patient and adjusts the radiation path as necessary. Children who can understand the importance of holding still can undergo the treatment while conscious, younger kids can have short term anesthesia for approximately hour – long diagnostic and treatment session. The recovery from anesthesia is usually quicker because they don’t usually have to be intubated.

At Apollo specialty hospital, till date we had the opportunity to treat 11 children with Cyberknife radio surgery. Our first Cyberknife patient was a pediatric patient with cervico medullary haemangioblastoma 15 years male patient from Tripura . He presented with neck pain, poor cough reflex, and difficulty in swallowing and upper limb tingling sensation. Investigations revealed cervico medullary expansile lesion involving medulla to C2 C3 level.

He underwent occipito cervical craniotomy and decompression, because of high vascularity, surgery was abandoned. He underwent Cyberknife radio surgery between 24th to 26th March 2009. In the first follow up after 3 months, his symptoms completely disappeared follow up MRI showed reduction in size of lesion and contrast enhancing portion of the lesion reduced significantly.

This boy really benefited out of Cyberknife radio surgery. Treating only the affected area with out affecting adjacent brain tissue. He is due for his 10th Std board exam now.

Intracranial


We have treated 4 patients with AVM, and other treated indications include :


1 patient with Supracellular Hemartoma


1 patient with pineliocytoma


1 patient with Recurrent Meningioma


1 patient with Brainstem Glioma


1 patient with Pilocytic astrocytoma (residual)


Spine


1 patient with vertebral Haemangioma


To conclude, Cyberknife: represents an entirely new approach to radiosurgery. It is the only system that combines robotics, and advanced image guidance to deliver frameless radio surgery.

Cyberknife features robotic arm and proprietary image guided technology. The robotic arm is computer controlled and has an arm movement precision of 0.5mm.

Greatest advantage is an out patient basis treatment.


FOR MORE INFORMATION REGARDING CYBERKNIFE TREATMENT IN PEDIATRIC CASES YOU MAY BLOG YOUR COMMENTS OR WRITE TO lakshmipriya_b@apollohospitals.com

DR. SURESH H.ADVANI at APOLLO SPECIALITY CANCER HOSPITAL - CYBERKNIFE CENTER.

Padma Bhushan Prof.(Dr.) Suresh H.Advani , a well known renowned specialist in Oncology visited Apollo Speciality Cancer Hospital recently.

He visited our Cyberknife facility and during a recent interview to" News Today "had the following to say :
‘I used to refer cancer patients to Malaysia where the CyberKnife procedure was available and now Apollo Hospitals, Chennai, has acquired the latest Asia Pacific’s most advanced CyberKnife robotic radiosurgery system, PET scanning, MRI, Radiography, bone marrow transplant unit which is to be set up at the earliest, with expertise in the field, all under one roof that makes Chennai city the medical destination,’ said Dr Suresh Advani


To read the interview with dr. Suresh H,Advanui please log on to www.newstodaynet.com  Monday, 23 November, 2009



 
 
It was our previlige to have him here and get his valued opinion

DR.ADVANI in the center, with the cyberknife panel of  radiation oncologits at Apollo Speciality Cancer Hospital .

 
 
 
FOR FURTHER INFORMATION ON CYBERKNIFE TREATMENT,PLEASE  BLOG YOUR COMMENTS OR WRITE TO lakshmipriya_b@apollohospitals.com
 

CYBERKNIFE IN LUNG CANCER

Dr.Sanjay Chandrasekar, Senior Consultant Radiation Oncology presented on Cyberknife in Lung Cancer in the 11th Napcon 2009 (National Conference of Indian Chest Soceity ) conference in Calicut betweeb 5-8th November 2009.

The excerpts from his presentation on Cyberknife in Lung Cancer are :

FOR MORE INFORMATION ON CYBERKNIFE TREATMENT IN LUNG CANCER YOU CAN BLOG YOUR COMMENTS OR WRITE TO lakshmipriya_b@apollohospitals.com

CYBERKNIFE SUCCESS STORY FEATURED IN "THE WEEK" magazine

The 1st Cyberknife Success Story , featured in " The Week " Nov 15 edition on Week-IMRB exclusive survey on Best Hospitals 2009.

The Success story of Master Sanka Subradey , aged 15 from Tripura was the 1st Patient in India to undergo Cyberknife Treatment at Apollo Speciality Cancer Hospital, Chennai.

Post treatment , the follow up in September 09 showed in MRI significant reduction in tumour size & he is back to normal life busy preparing for his Class X board examination , thanks to Robotic Radiosurgery system like Apollo Cyberknife

FOR MORE INFORMATION ON TREATMENT PLEASE WRITE TO lakshmipriya_b@apollohospitals.com

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

Is the cyberknife really a knife?

Is the CyberKnife really a ‘knife’?
Though its name conjures up images of a scalpel – the CyberKnife in fact is the alternative to surgery! It is a Robotic Radiosurgery System. It is non-invasive procedure ideal for the treatment of both cancerous and non-cancerous tumors anywhere in the body. It uses image guided technology and computer controlled robotics to continuously track, detect and correct for tumor and patient movement throughout the treatment allowing for its extreme precision.
Here are more FAQs about the cyberknife:
1. Will a CyberKnife procedure be like a minor surgery?
In fact, much less strenuous! It involves no incisions, no blood, no anesthesia, and virtually no recovery time.

2. What does non-invasive procedure mean?
- It simply means that the procedure involves no invasion into the body – which means no cuts or incisions are made during the CyberKnife procedure.

3. How does a CyberKnife work?
- CyberKnife performs robotic radiosurgery during which precise radiation beams are focused on tumors while minimizing damage to surrounding healthy tissue.

4. Will patients have to get admitted to the hospital for this procedure?
- Certainly not. CyberKnife is a simple, outpatient procedure. Patients can undergo their treatment and immediately resume normal activities – as the side effects are minimal.

5. How long will the session last?
- Each treatment session may be between 30 - 90 minutes, depending on the type and location of the tumor. Sometimes the treatment is offered in stages in which case patients may have to return for additional sessions over a few days (not more than a week) – as advised by the doctor.

6. What are the pre-preparations for this treatment?
- Before starting treatment, the medical team will perform a high resolution CT scan to determine the size, shape and location of the tumor. Once this data is obtained it is transferred to the Cyberknife database and the treatment is planned in detail.

7. What can one expect during a CyberKnife treatment?
- Each case is unique depending on the health of the patient and the type as well as location of the tumor. Some patients need just one sitting while other may need to come for repeat sessions. A detailed orientation is given to patients – based on their specific case so that they know what to expect before they go in for treatment.

8. What types of conditions are considered for CyberKnife treatment?
- The CyberKnife is capable of treating tumors anywhere in the body, but its precision makes it ideal for sensitive zones like the brain, spine, lung, prostate, liver and pancreas.

9. They say CyberKnife does not require a headframe – what does that mean?
- Radiation treatment needs to be extremely precise – wrong tissues exposed to radiation could cause irreparable damage. Hence traditional radiation treatment like Lenear Accelerator use headframes or immobilization devices that are used to hold patients still. These could be extremely uncomfortable and painful. But CyberKnife eliminates all that! It has a built in sensor that only works at a particular body rhythm,. When the rhythm varies or when there is body movement (like coughing or sneezing) it automatically stops functioning.

11. Who determines if CyberKnife is the ideal treatment option for a particular case?
- The physician or a specialist can determine if CyberKnife is the ideal treatment option after evaluating the condition of the patient.

12. Can the elderly and children be treated with the CyberKnife?
- In most cases – yes. CyberKnife is less risky than traditional surgery as it involves no incisions at all. This makes it a suitable option for the elderly and the very young. The decision to perform the procedure will however be taken in consultation with the concerned physicians and anesthesiologist. The safety and comfort of the such patients are always kept in mind.

13. How is CyberKnife different from traditional Radiosurgery?
- While traditional radiosurgery methods (like the Linear Accelerator or Gamma Knife) worked on the same principle of focused radiation beams – none of the previous forms of treatment offered the precision and flexibility that CyberKnife does. Because of its robotic arm like structure the Cyberknife can reach tumors at angles that were previously inaccessible. Moreover CyberKnife uses a combination of a robotic arm, linear accelerator (high energy X-ray source), and image guidance technology – to give high precision results.

14. What are the advantages of CyberKnife?
- It has several inherent advantages. It is a pain free, non-invasive, outpatient procedure and the patients need virtually no recovery time. Moreover, there are no intrusive body or head frames and no breath-holding required during the procedure.

15.Is the CyberKnife safe?Being a non-invasive procedure, the CyberKnife is radically different from traditional surgery. It requires no anesthesia, no incision, no bleeding and no post-operative pain or unpleasant anesthesia after effects. Because of its precision, CyberKnife does not affect the surrounding healthy tissues thereby minimizing side effects – something that is not always possible with traditional radiation therapy.

16. After treatment, when will my tumor or lesion disappear?The effects of radiosurgery are not always immediately visible. Tumors also behave differently – depending on their location and the patient’s metabolism. Some tumors resolve more slowly than others and may or may not eventually disappear completely, while others simply stop growing and present no further biologic activity. After CyberKnife treatments patients will need to periodically undergo tests to assess their progress.

17. Will CyberKnife cause hair fall out or skin burn?The radiation delivered by the CyberKnife is so focused on a specific target that it is highly unlikely that hair loss or skin burn will occur. In the event that a treated lesion is very close to the scalp or skin though, the adjacent hair or skin may be affected. If so affected, this hair or skin will typically recover over time. All medical procedures, including CyberKnife treatment, have potential side effects and associated risks, and every patient will be individually evaluated and counseled in detail before a final plan of treatment is made.

18. Where in India can patients go for CyberKnife treatment?
Apollo Hospitals, Chennai, is the only hospital in India to have the CyberKnife. It is not just India’s first, but also Asia’s most advanced CyberKnife. Apollo Hospitals has trained technicians, doctors and counselors who can guide patients through the treatment process.

19. What are the facilities available for cancer care at Apollo Hospitals? Apollo Hospitals, across India have dedicated centers that offer comprehensive cancer care. The hospital's cancer centers have experienced surgical and radiation cancer specialists as well as diagnostic consultants. The center's teams of doctors examine each case jointly and decide on the best line of treatment for the patient. Since treatment of cancer involves tremendous physical and emotional strain, the hospital provides extra support to cancer patients by counseling them to stay positive and to eat right - thereby speeding up the recovery process. Specially trained medical counselors, speech therapists, dieticians and other professionals, appropriate to the individual case, provide support to the teams of doctors. The measurable success that the hospital has achieved in cancer care attracts thousands of national and international patients each year

Cyberknife

The CyberKnife® is a state-of-the-art, radiotherapy equipment for robotic radiosurgery that allows radiation oncologists to treat pathologies painlessly, without the need for an operation.
CyberKnife® uses pencil beams of radiation which can be directed at any part of the body, from any direction with the help of a robotic arm. The system tracks the tumour's position, detects any movement of the tumour or patient, and automatically corrects its positioning .It then targets the tumour with multiple beams of high-energy radiation, destroying abnormal tissue without damaging surrounding areas.The treatment is so accurate that it's now possible to treat tumours previously thought to be inoperable. Although the results of treatment do not always show immediately, in most cases, the procedure will initially stop the growth of tumours, before gradually reducing their size.As there is no open surgery, the risk complications normally associated with an operation are eliminated, as is the need for a long recovery time. This makes treatment suitable even for those who are not well enough to cope with surgery. Most patients leave the hospital the same day.