What to Expect

An effective alternative to surgical treatment

The unparalleled precision and motion synchronization capabilities of the CyberKnife® System maximize radiation delivered to the target — while helping to minimize dose to surrounding healthy tissues. The result is highly effective treatment that helps to preserve liver function, eliminates many of the inconveniences of other treatments, and significantly reduces the risk of the side effects of open surgery that too often disrupt the lives of patients during and after treatment.


CyberKnife treatment is an outpatient procedure that does not require incisions or general anesthesia. Prior to the initiation of treatment, fiducials will need to be implanted within the liver through a minimally invasive procedure, to track the movement of the tumor. Most patients will not require hospitalization or a long recovery period.


CyberKnife treatment is completed in as little as 1-5 sessions, over 1-2 weeks.


The CyberKnife System delivers the required radiation dose to the tumor with sub-millimeter precision, helping to preserve liver function and significantly reducing the side effects associated with liver surgery1.

A faster return to everyday life

With CyberKnife treatment, the majority of patients can continue normal activity during and immediately following treatment — compared to the typical recovery period that comes with traditional surgery. Just as importantly, the CyberKnife System can help reduce the risk of common side effects associated with surgery, protecting quality of life both during and after treatment. In some circumstances, side effects may occur.

Your CyberKnife Treatment Process


The CyberKnife System treatment process begins with a consultation with a radiation oncologist who will provide perspective on this as a treatment option specific to your condition. The physician will review your biopsy results, imaging and other medical conditions.


Liver cancer treatment with the CyberKnife System involves a multi-disciplinary team approach, which may include several specialists:

  • Gastroenterologist
  • General Surgeon
  • Medical Oncologist
  • Radiation Therapist
  • Radiation Oncologist
  • Medical Physcist
  • Dosimetrist
  • Medical Support Staff


Tumors will require the placement of fiducials within the liver. Fiducials are markers that show on x-ray to help the CyberKnife System pinpoint the tumor’s exact location. They are implanted in a short, minimally invasive outpatient procedure prior to treatment planning.


Prior to CyberKnife treatment, you will undergo imaging scans so that your treatment team can determine the exact size, shape and location of your liver tumor using the position of the fiducials, as well as nearby anatomy.


As part of the preparation process, you will be fitted for a personalized body cradle designed specifically to make treatment more comfortable for you while ensuring your body position is the same for each treatment session. You will also be fitted with a special vest, which is worn during treatment and enables the CyberKnife robot to synchronize treatment delivery with your natural breathing.


Following these preparatory visits, you will return for treatment planning. Using CT, MRI and/or PET scan data, your treatment team will determine the area targeted by radiation, the radiation dose, and identify critical structures — such as the duodenum or the bowel– where radiation should be avoided.

The medical physicist will then calculate a precision-optimized radiation delivery plan, leveraging the CyberKnife System’s extreme maneuverability to help deliver an accurate treatment.


Approximately one to two weeks after your treatment plan is finalized, you will begin treatment sessions.

There are typically 1-5 treatment sessions of short duration over 1-2 weeks. During treatment, the CyberKnife System’s computer-controlled robot will move around your body to various locations from which it will deliver radiation. At each pre-defined position, it will stop to precisely deliver the dose while correlating your breathing motion with the tumor position.

Treatment sessions are non-invasive outpatient procedures, and nothing will be required of you during treatment. No patient restraints. No breath holds. No anesthesia.


Most patients experience minimal side effects and can quickly return to their daily routines with little interruption to their normal activities.

Your medical team will discuss all possible side effects prior to treatment and may prescribe medication to control any side effects, should they occur. You also should schedule and attend any follow-up appointments.

Learn More About Side Effects

Find a CyberKnife Treatment Center

Learn More About CyberKnife Treatment


1 Yuan Z et al. “Comparative research on the efficacy of CyberKnife® and surgical excision for Stage I hepatocellular carcinoma.” Onco Targets Ther. 2013 Oct 29;6:1527-32. doi: 10.2147/OTT.S51452. eCollection 2013.

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Important Safety Statement: Most side effects of radiotherapy, including radiotherapy delivered with Accuray systems, are mild and temporary, often involving fatigue, nausea, and skin irritation. Side effects can be severe, however, leading to pain, alterations in normal body functions (for example, urinary or salivary function), deterioration of quality of life, permanent injury and even death. Side effects can occur during or shortly after radiation treatment or in the months and years following radiation. The nature and severity of side effects depend on many factors, including the size and location of the treated tumor, the treatment technique (for example, the radiation dose), the patient’s general medical condition, to name a few. For more details about the side effects of your radiation therapy, and if treatment with an Accuray product is right for you, ask your doctor.