The CyberKnife System uses state-of-the-art robotics and advanced software technology, but it is not new. The CyberKnife System has over a decade of clinical evidence and has been used to help thousands of patients with liver cancer. The CyberKnife System is used to treat liver cancers using a procedure called stereotactic body radiation therapy (SBRT). It is an effective option for patients who cannot undergo surgery or radiofrequency ablation, and/or whose tumors cannot be completely removed surgically. The CyberKnife System can also be used as a bridge to transplantation.¹

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

CyberKnife treatment eliminates the discomfort and risk associated with inserting a needle-like probe into the tumor through the skin.

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, preventing them from growing and dividing. The goal of any radiation treatment is to destroy cancer cells while minimizing side effects on healthy tissue. As imaging technologies have improved over the past few decades, radiation therapy has incorporated these improvements to optimize dose delivery and minimize side effects.

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

Stereotactic body radiation therapy (SBRT) combines a high degree of localization accuracy with very high doses of extremely precise radiation delivered externally, thereby maximizing the cell-destroying effect on the tumor(s) while minimizing radiation-related injury to adjacent normal tissues.

High-dose, hypofractionated SBRT delivered by the CyberKnife System has emerged as an innovative treatment option — showing promising efficacy with low toxicity for primary liver cancer (e.g., hepatocellular carcinoma) and metastatic liver tumors.3, 4

In addition, the CyberKnife System can also be used as a bridge to transplantation.1

There are numerous options for treating liver cancer, and the right one depends on the specific location of your tumor, the type of cancer, and its aggressiveness—as well as your overall health, age, and lifestyle. The CyberKnife System 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 schedule an appointment to discuss your specific needs.

Despite the higher dose rate associated with SBRT, the CyberKnife System's efficacy for primary liver cancer is equivalent to surgery with fewer adverse events.² The ability to adapt to movement and deliver precise radiation doses allows clinicians to minimize irradiation of the healthy liver and surrounding organs at risk, and reduce toxicity.⁵ Most patients resume normal activity immediately after treatment sessions. However, side effects can and do occur. Most radiation side effects are minimal and short-lived. However, side effects can be serious.

CyberKnife treatment is usually completed in just 1-5 sessions over 1-2 weeks.

The treatment sessions are non-invasive outpatient procedures and do not require anesthesia. Most patients resume normal activity immediately after the treatment sessions.

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

The CyberKnife System was designed to provide the clinical team with a powerful tool to effectively manage cancer while minimizing side effects and the impact of treatment on patients' daily lives. Most patients can continue normal activity during and immediately after 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 submillimeter accuracy throughout the treatment. This greater precision helps minimize the dose to surrounding healthy tissue, preserving liver function and reducing the risk of side effects.

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

During treatment, a liver tumor will move and deform continuously throughout the administration of the treatment.

Failure to adapt and synchronize radiation dose delivery with tumor movement can result in a decreased dose delivered to the target—and an increased dose delivered to healthy liver tissue and surrounding organs at risk. This can affect the overall effectiveness of treatment and potentially increase the incidence and severity of side effects—including reduced liver function.

Unlike any other radiation treatment, the CyberKnife System uses the world’s only real-time motion synchronization technology to continuously track that movement and adapt treatment delivery for submillimeter accuracy. This ensures that the radiation dose is delivered to the target—maximizing treatment effectiveness while minimizing the dose to surrounding tissues to reduce the incidence of side effects. And unlike other radiation therapy options, the CyberKnife System requires no uncomfortable patient restraint or breath-holding techniques; you can relax and breathe normally, with complete confidence in CyberKnife’s timing capabilities.

Precisely delivering the prescribed radiation dose to the target is essential to reduce toxicity and preserve liver function.

Because many patients with liver cancer already have compromised liver function, minimizing damage to healthy liver cells is critical to preserving optimal liver function. Furthermore, the liver is surrounded by sensitive organs and tissues, making precise administration important to reduce the incidence and severity of side effects and protect quality of life both during and after treatment.

SBRT is a form of hypofractionated radiation therapy. Hypofractionation involves delivering a higher dose per fraction in a smaller total number of fractions. Hypofractionated radiation therapy, such as liver SBRT, has been shown to provide clinical outcomes as good as surgery with fewer adverse events² — while dramatically reducing both the number of treatments and the overall cost of care for both patients and payers.

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

Compelling clinical evidence demonstrates that hypofractionated, high-dose radiosurgery delivered by the CyberKnife System can offer sustained tumor control with a low risk of severe toxicity and clinical outcomes similar to surgery with milder adverse events.2

• A study of 75 patients with liver cancer treated using the CyberKnife System found that 89.8 percent of patients showed no cancer progression beyond the liver two years after treatment. Overall survival at one year follow-up was 78.5 percent and at two years follow-up was 50.4 percent.⁶

• A study evaluating the efficacy and toxicity of SBRT in the treatment of 57 patients with liver metastases showed that more than 85 percent of patients achieved local tumor control two years after treatment, without serious toxicities. The overall survival rate at two-year follow-up was 55.9 percent. SBRT with the CyberKnife System is an effective alternative for patients with liver metastases who are not candidates for surgery and/or whose tumors cannot be completely removed surgically.⁴

Because the CyberKnife System's precise localization significantly reduces irradiation of healthy liver tissue and surrounding organs at risk, patients treated with CyberKnife are often excellent candidates for re-irradiation in the event of recurrence.

Because the CyberKnife System's precise targeting significantly reduces irradiation of healthy liver tissue and surrounding organs at risk, it can provide a safe radiation treatment option even for patients who have previously received radiation therapy. Each patient should consult with their physician regarding their specific case.