Robotic Radiosurgery System Used To Treat Spinal Tumors

A new study shows the potential of radiosurgery in improving long-term palliation of pain in patients with spinal metastases, especially those with solitary sites of spine involvement.
Researchers at the University of Pittsburgh Medical Center (Pittsburgh, PA, USA) conducted a study on the effectiveness of the CyberKnife robotic radiosurgery system. The study included 500 patients who underwent treatment; ages ranged from 18 to 85 years (mean 56). Lesion location included 73 cervical, 212 thoracic, 112 lumbar, and 103 sacral lesions. The maximum intratumoral dose ranged from 12.5 to 25 Gy (mean 20). Tumor volume ranged from 0.20 to 264 ml (mean 46).
The results showed that long-term pain improvement occurred in 290 of 336 cases (86%). Long-term tumor control was demonstrated in 90% of lesions treated with radiosurgery as a primary treatment modality and in 88% of lesions treated for radiographic tumor progression. Twenty-seven of 32 cases (84%) with a progressive neurologic deficit before treatment experienced at least some clinical improvement. The results of the study were published in the January 15, 2007, issue of the journal Spine.

"We've had tremendous success with the CyberKnife system in treating patients with complex spinal tumors,” said lead author Dr. Peter Gerszten. "The results of our study demonstrate the CyberKnife System's effectiveness in controlling tumor progression and minimizing any associated side effects.”

The CyberKnife robotic radiosurgery system combines continuous image-guidance technology with a compact linear accelerator that has the flexibility to move in three dimensions according to the treatment plan. The system uses the internal anatomy to directly track tumors without the need for external frames or implanted fiducials. The system registers unique non-rigid and bony anatomy landmarks to track, detect, and correct for the movement of the spine in real-time throughout the treatment, allowing doctors to deliver high doses of radiation with sub-millimeter accuracy while avoiding damage to healthy tissue. The system is made by Accuray (Sunnyvale, CA, USA).


Related Links:
University of Pittsburgh Medical Center
Accuray