The CyberKnife System uses state-of-the-art robotics and advanced software technology, but it's not new. The CyberKnife System has over two decades of clinical evidence and has been used to help thousands of patients with pancreatic cancer.

Studies support SBRT treatment with CyberKnife as a safe, effective, and convenient option with proven clinical benefits for patients with advanced, medically inoperable pancreatic cancer and pancreatic cancer that has recurred after primary treatment such as surgery or radiation:

• A clinical study evaluating 56 patients with locally advanced unresectable pancreatic cancer found that treatment with a combination of SBRT with CyberKnife and chemotherapy resulted in excellent efficacy with acceptable toxicity. The use of Synchrony® real-time adaptive technology during CyberKnife treatment allowed for continuous tumor tracking as they moved with the patients' breathing and automatic adaptation of the radiation beam, minimizing the dose to healthy tissues such as the stomach and duodenum surrounding the tumor.¹

• A study of 417 patients with advanced or medically inoperable pancreatic cancer found that stereotactic body radiation therapy delivered with the CyberKnife System is safe and effective for elderly patients and an alternative for those patients who are not candidates for surgery2.

• An analysis of 19 patients with unresectable pancreatic cancer found that SBRT with CyberKnife is an effective local treatment option with acceptable rates of adverse events. The study authors noted: “In the multidisciplinary management of these tumors, SBRT adds to our arsenal of local treatment modalities, especially for inoperable patients.”3

• An analysis of 38 patients treated with SBRT with CyberKnife and chemotherapy for locally advanced and inoperable pancreatic cancer indicates that the combined treatment is feasible, generally well tolerated and convenient — CyberKnife treatments were administered in 5 sessions avoiding interruption of the patients' chemotherapy regimen4.

• An analysis of 30 patients with recurrent pancreatic cancer after prior radiotherapy was performed. Due to its precise targeting and avoidance of normal tissue, CyberKnife proved to be a feasible, effective, and tolerable treatment option.⁵

• A study of 59 patients evaluated the efficacy and safety of CyberKnife treatment for locally advanced pancreatic cancer (LAPC). The authors concluded that “excellent clinical efficacy was achieved after treatment of LAPC using CyberKnife, with minimal toxicity.” Most patients experienced good local control of their tumors. Local control of pancreatic tumors can improve pain management and reduce the risk of gastric or duodenal obstruction.⁶

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

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CyberKnife System treatment is a non-surgical, outpatient procedure that requires no incisions or general anesthesia. Most patients will not require hospitalization or a lengthy recovery period. This makes CyberKnife treatment an excellent option for patients with medically inoperable pancreatic cancer.

The CyberKnife System was designed to deliver stereotactic body radiation therapy (SBRT), a treatment process that has proven effective in treating pancreatic cancer. SBRT uses advanced techniques to deliver ultra-hypofractionated radiation therapy—very high doses of radiation are delivered over several days. Treating in fewer sessions with higher individual doses per session is typical of SBRT and has proven to be an effective approach. This treatment process requires an extremely high degree of accuracy and precision.

The entire CyberKnife treatment course is typically completed in as few as 5 sessions, compared to 20 to 30 sessions over 4 to 6 weeks with conventional radiation therapy. Because CyberKnife SBRT can be completed in as few as 5 sessions, it generally does not require interrupting or delaying chemotherapy treatment, which is very often combined with radiation therapy.

Radiation therapy is a treatment that uses high-energy X-rays (photons) to kill and shrink tumors or control their growth. 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 in recent decades, radiation therapy has incorporated these improvements to optimize dose delivery and minimize unwanted radiation to healthy tissue.

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.

Due to the pancreas's location and position—adjacent to numerous sensitive tissues and organs such as the stomach and duodenum—extreme precision is critical for any treatment method. SBRT with CyberKnife allows treatment teams to deliver very high doses of radiation with continuous submillimeter accuracy, while minimizing the dose to surrounding healthy tissues. Furthermore, because SBRT with CyberKnife can be completed in as few as five sessions, it generally does not require interrupting the chemotherapy cycle.

There are more options than ever before for treating pancreatic cancer, and the right option depends on the specific location of your tumor, the type of cancer, and its aggressiveness—as well as your overall health, age, and lifestyle. SBRT with CyberKnife may be a suitable 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 per session associated with SBRT, multiple studies have validated that SBRT with CyberKnife is generally well-tolerated with minimal side effects. The ability to deliver precise radiation doses allows clinicians to minimize irradiation of healthy tissues surrounding the tumor and the risk of side effects, which can lead to a better quality of life for the patient both during and after treatment. Nevertheless, side effects can and do occur. Most radiation side effects are minimal and last only a short time. Most patients resume normal activity immediately after treatment sessions.

CyberKnife treatment is typically completed in as few as 5 sessions, compared to 20 to 30 sessions over 4 to 6 weeks with conventional radiotherapy.

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

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

Most patients can continue with normal activity during and immediately after CyberKnife treatment. 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, which can reduce the risk of many common side effects.^7,8

When you breathe, your diaphragm moves. This means that a pancreatic tumor will move continuously throughout treatment. In addition, anatomical changes (such as those due to normal digestion) can cause the pancreas to shift slightly.

Failure to adapt and synchronize radiation dose delivery with tumor movement can result in a decrease in the dose delivered to the target—and an increase in the dose delivered to surrounding healthy tissue. This can affect the overall effectiveness of treatment and potentially increase the frequency and severity of side effects.

Unlike any other radiation treatment, the CyberKnife System uses the world’s only real-time motion timing technology to continuously track that movement and adapt treatment delivery for submillimeter accuracy. This helps ensure the radiation dose is delivered to the target—maximizing treatment effectiveness while minimizing the dose to surrounding tissues, which can help 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 the CyberKnife System’s timing capabilities.

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

Because the pancreas is adjacent to several sensitive organs and tissues within the abdomen, accurate administration is critically important to reduce the incidence and severity of side effects and to 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 pulmonary SBRT, has been shown to provide clinical outcomes as good as conventional fractionation—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 negative 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.

The use of SBRT with CyberKnife is supported by extensive clinical evidence demonstrating that the treatment can provide a convenient and effective option for patients with locally advanced and medically inoperable pancreatic cancer.

Because the CyberKnife System's precise targeting significantly reduces irradiation of surrounding healthy tissue, patients treated with the CyberKnife System may be candidates for re-irradiation in the event of recurrence. Furthermore, patients treated with the CyberKnife System may occasionally be candidates for surgical intervention in the event of recurrence.

Because the CyberKnife System's precise targeting significantly reduces irradiation of surrounding healthy tissue, 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 with their physician regarding their specific case.