LUNG CANCER

Frequently Asked Questions

The CyberKnife System uses leading-edge robotics and advanced software technology, but it’s not new. The CyberKnife System has more than two decades of clinical evidence and has been used to help thousands of men and women with lung cancer to take control of their disease.

  • The CyberKnife System is a leading technology in SBRT, a specialized type of radiation therapy, used to treat early stage, inoperable non-small cell lung cancer while minimizing side effects.1
  • The CyberKnife System enables safe and effective SBRT for central lung tumors surrounded by sensitive structures2 and lung tumors near the chest wall3.
  • The CyberKnife System also provides excellent clinical outcomes for patients with inoperable peripheral lung tumors1, 4 ,5.
  • A pooled analysis of two randomized trials indicates that lung SBRT is better tolerated and might lead to better overall survival compared to surgery for operable early-stage lung cancer6.

See The Clinical Evidence

The FDA provided clearance for the CyberKnife System in 2001 for the treatment of tumors anywhere in the body, including the lungs.  The CyberKnife System is supported by years of published clinical follow-up with a large number of patients.

CyberKnife treatment is available at hundreds of locations worldwide.

Find a Treatment Center Near You

Treatment with the CyberKnife System is a non-surgical, outpatient procedure that does not require incisions or general anesthesia. Most patients will not require hospitalization or a long recovery period. This makes CyberKnife treatment an excellent option for medically inoperable lung cancer patients and those seeking an alternative to surgery.

CyberKnife treatment is typically completed in as little as 3 to 4 sessions over 1 to 2 weeks, compared to 20 to 30 sessions over 4 to 6 weeks with conventional radiation therapy.

CyberKnife treatment eliminates the inconvenience and risk associated with seed implants.

Radiation therapy is a treatment that uses high-energy X-rays (photons) to kill, shrink or control the growth of tumors. Radiation therapy works by damaging cells, disabling them from growing and dividing. The goal of any radiation treatment is to destroy cancer cells while minimizing the side effects on healthy tissue. As imaging technologies have improved over the last several decades, radiation therapy has integrated those improvements to enhance dose delivery and minimize side effects.

Radiation may be recommended as an alternative to surgery or in addition to other therapies. There are several kinds of radiation therapy. The CyberKnife System delivers a type of radiation therapy known as stereotactic body radiation therapy (SBRT).

Stereotactic Body Radiation Therapy (SBRT) couples a high degree of targeting accuracy with very high doses of extremely precise, externally delivered radiation, thereby maximizing the cell-killing effect on the tumor(s) while minimizing radiation-related injury in adjacent normal tissues.

The hypofractionated, high-dose SBRT treatment delivered by the CyberKnife System has improved tumor control and patient survival when compared to conventional radiotherapy for patients with inoperable stage 1 non-small cell lung cancer.

Additionally, compared to conventional radiation therapy that requires approximately 20 to 30 sessions over several weeks, lung SBRT can typically be completed in 3 to 4 sessions over 1 to 2 weeks.

There are more options than ever for treating lung cancer, and the right option depends on your specific tumor location, cancer type and cancer aggressiveness — as well as your health, age and lifestyle. CyberKnife is an ideal treatment option for a wide range of cancer types and patient situations. The best way to determine if CyberKnife treatment is right for you is to find a CyberKnife treatment location and make an appointment to discuss your specific details.

Find a Treatment Center Near You

Despite the higher dose rate associated with SBRT, multiple studies have validated that CyberKnife SBRT is well tolerated with minimal side effects. The ability to deliver precise doses of radiation enables clinicians to decrease exposure to surrounding healthy tissue and minimize negative side-effects on surrounding healthy tissues and organs. Most patients resume normal activity immediately after treatment sessions. Nonetheless, side effects can and do occur. Most radiation side effects are minimal and last only a short time.

Click Here for More Information on Potential Side Effects

CyberKnife treatment is typically completed in as little as 3 to 4 sessions over 1 to 2 weeks, compared to 20 to 30 sessions over 4-6 weeks with conventional radiation therapy.

Treatment sessions are non-invasive outpatient procedures, and no anesthesia is required. Most patients resume normal activity immediately after treatment sessions.

No anesthesia is required for CyberKnife treatment and treatment sessions are completed on an outpatient basis. Some tumors may require the placement of fiducials within the lung. This procedure would be performed under local anesthesia.

The CyberKnife System was designed to provide the clinical team with a powerful tool to effectively control the cancer while minimizing side effects and the impact of treatment on patients’ daily lives. The majority of patients can continue normal activity during and immediately following CyberKnife treatment — compared to the typical requirement to limit normal activity several weeks after traditional surgery. In some circumstances, complications may occur.

The majority of patients can continue normal activity during and immediately following CyberKnife treatment — compared to the typical requirement to limit normal activity for several weeks after traditional surgery. The majority of patients can continue normal activity during and immediately following CyberKnife treatment — compared to the typical requirement to limit normal activity for several weeks after traditional surgery. In some circumstances, complications may occur.

The CyberKnife robot, guided by motion synchronization software, can deliver radiation from virtually any angle — allowing it to maintain sub-millimeter accuracy throughout treatment delivery. Greater precision helps minimize dose to surrounding healthy tissues, reducing the risk of many common side effects7, 8.

When you breathe, your torso moves — often as much as several centimeters in as little as a few seconds. This means that a lung tumor — or other targets located near the lungs — will continuously move throughout the course of treatment delivery.

Failing to adapt and synchronize the delivery of radiation dose with tumor movement can result in decreased dose delivered to the target — and increased dose delivered to surrounding healthy tissues. This can impact the overall effectiveness of the treatment and can potentially increase the incidence and severity of side effects.

Watch How The Cyberknife Synchronizes With Target Motion

Unlike any other radiation treatment, the CyberKnife System uses the world’s only real-time motion synchronization technology to continuously continually track that motion and adapt treatment delivery to maintain sub-millimeter accuracy. This helps to ensure the radiation dose is delivered to the target — maximizing treatment effectiveness while minimizing dose to surrounding tissues to help reduce the incidence of side effects. And unlike other radiotherapy options, the CyberKnife System does not require uncomfortable patient restraints or breath-hold techniques; you can relax and breathe normally, with full confidence in the CyberKnife’s synchronization capabilities.

Precisely delivering the prescribed radiation dose to the target is essential for optimizing long-term cancer control. Additionally, precise dose delivery reduces irradiation of healthy tissues surrounding the target.

Because the lungs are surrounded by sensitive organs and tissues, precise delivery is critically important for reducing the incidence and severity of side effects and protecting quality of life both during and after treatment.

SBRT is a form of hypofractionated radiation therapy. Hypofractionation entails delivering a higher dose per fraction across fewer total fractions. Hypofractionated radiation therapy, such as lung SBRT, has been proven to deliver clinical outcomes as good as conventional fractionation — while dramatically reducing both the number of treatments and the total cost of care for both patients and payers.

Despite the higher dose rate associated with SBRT, multiple studies have validated that CyberKnife SBRT is well tolerated with minimal side effects. The ability to deliver precise doses of radiation enables clinicians to decrease exposure to surrounding healthy tissue and minimize negative side-effects that can reduce a patient’s quality of life. Most patients resume normal activity immediately after treatment sessions. Nonetheless, side effects can and do occur — and can be severe — with any treatment option and should be discussed with your physician.

Compelling clinical evidence shows that the hypofractionated, high-dose radiosurgery delivered by the CyberKnife System can offer improved tumor control and patient survival.10

  • The CyberKnife System is a leading technology in SBRT, a specialized type of radiation therapy, used to treat early stage, inoperable non-small cell lung cancer while minimizing side effects.9
  • The CyberKnife System enables safe and effective SBRT for central lung tumors surrounded by sensitive structures2 and lung tumors near the chest wall.3
  • CyberKnife also provides excellent clinical outcomes for patients with inoperable peripheral lung tumors1, 4, 5.
  • A pooled analysis of two randomized trials indicates that lung SBRT is better tolerated and might lead to better overall survival compared to surgery for operable early-state lung cancer.6

Because the precise targeting of the CyberKnife System significantly reduces irradiation of surrounding healthy tissues, patients treated with the CyberKnife System could be candidates for re-irradiation, in the event of recurrence. Additionally, patients treated with the CyberKnife System may sometimes be candidates for surgical interventions, in the event of recurrence.

Because the precise targeting of the CyberKnife System significantly reduces irradiation of surrounding healthy tissues, patients treated with conventional radiotherapy systems may be candidates for re-irradiation with the CyberKnife System, in the event of recurrence. Each patient should consult his/her physician regarding his/her own specific case.

As of January 2020, SBRT treatment for lung cancer is covered by Medicare in all 50 states and the District of Columbia. In addition, many private insurance payers cover SBRT treatment for lung cancer. It is always best to check your insurance policy and if applicable, be sure to review your employee contract to determine if your insurance coverage benefits are limited. If you live outside of the United States, typically the CyberKnife Center that you would choose for treatment can answer coverage questions.

Not every patient’s lung cancer is effectively treated with SBRT. Talk to your physician about your best options and come to a joint decision. If chest wall sarcoma or metastatic lung tumor treatments are required, as an example, Accuray’s Radixact® or TomoTherapy® System could be an option: Radixact and the TomoTherapy Systems leverage CT-image guidance to ensure highly conformal dose delivery to the tumor with each treatment.

1 Brown et al. “Application of Robotic Stereotactic Radiotherapy to Peripheral Stage I Non-small Cell Lung Cancer with Curative Intent.” Clin Oncol (R Coll Radiol). 2009; 21: 623-631.

2 Nuyttens J.J. et al. “Outcome of four-dimensional stereotactic radiotherapy for centrally located long tumors.” Radiotherapy and Oncology. 2012; 102: 383-387.

3 Podder T. et al. “Chest wall and rib irradiation and toxicities of early-stage lung cancer patients treated with CyberKnife stereotactic body radiotherapy.” Future oncology. 2014; 10(15): 2311-2317.

4 Snider J.W. et al. “CyberKnife with tumor tracking: an effective treatment for high-risk surgical patients with single peripheral lung metastases” Front Oncol. 2012; 2: 63 – https://doi.org/10.3389/fonc.2012.00063.

5 Lischalk J.W. et al. “Long-term outcomes of stereotactic body radiation therapy (sbrt) with fiducial tracking for inoperable stage I non-small cell lung cancer (nsclc).” J Radiat Oncol. 2016; 5: 379-387 – https://doi.org/10.1007/s13566-016-0273-4.

6 Chang S. et al. “Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two rancomised trials.” Lancet Oncol. 2015; 16(6) 630-637 – https://doi.org/10.1111/1759-7714.12574.

7 Drexler and Furweger. “Quality assurance of a robotic, image guided radiosurgery system.” WC 2009, IFMBE Proceedings 25/I, 492-495, 2009.

8 Kilby. W. et al. “The CyberKnife Robotic Radiosurgery system in 2010.” TCRT 2010;9(5):433-452.

9 Brown et al. Clinical Oncology 2009.06.006. Application of Robotic Stereotactic Radiotherapy to Peripheral Stage I Non-small Cell Lung Cancer with Curative Intent

10 Onishi H, Araki T, Shirato H, Nagata Y, et al. Stereotactic hypofractionated high-dose irradiation for stage I nonsmall cell lung carcinoma: clinical outcomes in 245 subjects in a Japanese multiinstitutional study. Cancer. 2004 Oct 1;101(7):1623-31.