Short course radiation therapy is the one of the most talked about subject in recent years and also a fascinating research zone. Hypofractionated (short course) radiation therapy is an old concept, but only in recent years with tremendous improvement in radiation therapy delivery technologies there is a significant visible surge in it’s applicability in clinical practice. Modern radiation therapy technology is capable of delivering high dose to the target while sparing majority of the adjacent critical structures. Hence, it is possible to deliver short course of treatment regimen with higher dose per fraction without increasing in toxicity. Apart from the intracranial lesions, there are emerging evidences about short course treatment schedule in ‘extracranial’ sites such as in lung, prostate, breast, pancreas and also in various ‘oligo metastasis’.
Shorter treatment regimens with Cyberknife are comfortable to both patients and caregivers. These regimens are more acceptable to the patient, have higher completion rate and have a definite positive influence in quality of life. However, hypofractionated treatment planning is demanding, highly skill dependent and needs strict quality assurance. Appropriate training of the treating physicians, physicists as well as radiation technologists is critical to have desired treatment outcome. In modern day medicine, quality of life is an important issue. Majority of the new advances in the management of diseases are focused to improve the quality of life parameters. Prolonged treatment duration is associated with poor quality of life and also increase depression among the patients. Shorter hospital stay and attendance to the medical facility is one of the measures to improve quality of life. Short course treatment with CyberKnife improves quality of life and ‘patient’s treatment acceptability’ is excellent.
Cyberknife is a high precision radiation therapy delivery system. It has a linear accelerator attached with a robot and is capable of treatment from various coplanar and non-coplanar field arrangements. Cyberknife has sub-millimeter accuracy and unmatched dose distribution. The advanced technology behind Cyberknife uses image guidance technology and computer-controlled robotics to deliver and extremely precise dose of radiation to targets, avoiding the surrounding healthy tissue, and adjusting for patient and tumor movement during treatment. It is the first system in the world designed to treat tumors anywhere in the body, with sub-millimeter accuracy.
Patient benefits from the Cyberknife are significant. Many of the complications associated with other conventional cancer therapies are minimized or eliminated by the Cyberknife System. Most Cyberknife treatments can be performed even on an outpatient basis. In addition, it is possible to treat multiple tumors at different locations in the body, during a single treatment session. Patients normally experience dramatic pain relief after Cyberknife treatment. Also, there is no anesthesia, recovery periods are short. Common indications of Cyberknife are cranial benign and malignant tumours, gall bladder and pancreatic cancer, prostate cancer, recurrent head and neck cancer. This recent revolution in radiation therapy has immense promise to treat with short course regimens with high dose and improve local control without increasing toxicities.
CyberKnife is a revolutionary invention and is the future of radiation therapy. In coming years with more and more centre having CyberKnife, we will able to treat many more patients with precise radiation therapy in shorter time without acute toxicity and cure more patients, maintain their quality of life.