What is a jetboiler?
.
In the late 1980s, a team led by Professor John Adler at Stanford University Medical Center began researching new stereotactic radiosurgery systems based on previous tumor treatment techniques, culminating in the invention of the radio-wave knife (cyberknife) after more than 10 years of work.
The Cyberknife is the world’s first whole-body stereotactic radiosurgery platform, a real-time image-guided, stereotactic robotic radiosurgery system, so it is also known as the “stereotactic radiosurgery platform,” the “cyberknife,” or the “computer knife. “It was approved by the FDA in 2001 as a radiosurgery device that can treat the entire body for non-invasive treatment of malignant and non-malignant tumors anywhere in the body, including the prostate, lungs, brain, spine, liver, pancreas, and kidneys.
This extremely high-precision irradiation of tumors with a single large dose of radiation (the only one in medical history with a precision of less than 1mm) is a great breakthrough in the treatment of tumors by improving efficacy while minimizing side effects of treatment.
Since then, the system has undergone many technological improvements and equipment upgrades, and in January 2008, the radio wave knife was featured in Forbes as a pioneering high-tech medical product and was named a “2008 Global Technology Pioneer” project by the World Economic Forum.
The newest model in use in China is the fourth generation of the radiofrequency knife, and individual hospitals have plans to introduce VSI models.
What are the advantages of radiofrequency knife for tumors?
The radiofrequency knife can treat tumors in all parts of the body, killing tumor tissue with only one to five irradiations, and is the only form of total body radiation surgery that combines the advantages of “no wound, no pain, no bleeding, no anesthesia, and a short recovery period”.
Specifically, it has the following outstanding advantages:
Synchronous tumor tracking
In some patients, tumors move with respiratory motion, at which point the radio wave knife can use cruise missile satellite positioning technology to track the tumor’s trajectory at different points in time and then instruct the manipulator to move simultaneously with the tumor’s motion, ensuring that the gas pedal is always aligned with the tumor during irradiation and minimizing damage to normal tissue.
Flexible robotic arm
In terms of form, the most significant feature of the CyberKnife is its precision, flexible robotic arm. It has a precision robotic arm with six degrees of freedom levels, providing optimal spatial expansion and mobility for treatment. At the same time, it has up to 1200 beams in different orientations, thus delivering irradiation doses to lesions throughout the body, truly enabling irradiation from any angle, greatly reducing damage to normal tissues and vital organs surrounding the tumor, while effectively reducing the occurrence of radiation complications.
Simultaneous treatment of multiple tumors
With thousands of incident beams, the radiofrequency knife can schedule multiple tumor “surgeries” in the same treatment plan, treating disparate tumors in different locations simultaneously. Of course, it can also treat tumors in irregular locations and irregularly shaped tumors, and early tumors smaller than 6 cm can be completely eliminated.
The whole process is painless
In the treatment of intracranial and near-spine tumors, the radio wave knife uses image-guided technology to precisely locate the patient’s position using bony markers on the skull or spine for non-invasive treatment. For tumors in the body, such as those in the lungs that are heavily influenced by respiratory motion, real-time, precise tracking is used to kill tumor cells using breath-tracking technology.
What side effects can be caused by radiofrequency knife treatment?
Although non-invasive, non-bleeding, and non-anesthetic, radiofrequency knife treatment can damage more or less normal tissue. After irradiation, patients with prostate cancer are exposed to relatively high doses of radiation at the tumor site, next to the tumor, perhaps within 0.5 cm or 1 cm, and the tissue in that area can become fibrotic. Therefore, the physician must determine whether the patient can tolerate this treatment and whether this damage will have a significant impact on the patient’s life.
What are the applications of the radiofrequency knife in the treatment of prostate cancer?
Radical treatment
The radiofrequency knife may be considered in combination with conformal radiotherapy and endocrine therapy for the radical treatment of limited prostate lesions in patients who meet the following criteria:
- Good general condition, pathologically confirmed prostate cancer, clinical stage <T2b, Gleason score ≤7, KPS score ≥60, no contraindications to puncture and cardiopulmonary;
- Clinical stage ≥ T2b, but the patient has no distant metastases.
Palliative care
The treatment of patients with metastatic prostate cancer is primarily endocrine therapy, and depending on the disease and associated factors, palliative treatment with the radio-wave knife may be used to improve their local control rate and relieve symptoms. For limited distant metastases, the radio-wave knife may provide palliative relief of symptoms or stabilize the progression of the lesion.
Which patients are not candidates for radiofrequency knife treatment?
Despite the many advantages of radiofrequency knife treatment, patients with the following conditions are not candidates for radiofrequency knife treatment:
- Extensive systemic metastases, very poor systemic condition, and KPS score below 40;
- Having a tendency to bleed;
- History of radical radiation therapy to the pelvis;
- Active intestinal bleeding within 2 weeks prior to treatment;
- Uncontrollable ascites.
What is the procedure of radiofrequency knife for prostate cancer?
- Three to five metal reference markers (gold markers) are implanted in the prostate under transrectal endoluminal ultrasound guidance approximately 10 days prior to the radiofrequency knife procedure to allow for timely image-guided localization and dynamic tracking of the moving prostate tumor like a laser-guided missile for “precision-guided”
- One week after implantation of the gold standard (after its position has stabilized), CT simulated localization is performed with the patient lying supine on the CT exam bed and the vacuum negative pressure bag immobilized for CT scanning. The CT images were transferred to the image fusion and contouring workstation via DICOM protocol.
- The prostate, seminal vesicles, rectum, bladder, penile bulb, and femoral head are then precisely outlined to distinguish between areas to be treated and areas to be protected, thus ensuring that the tumor tissue is completely destroyed without damaging the surrounding vital structures and avoiding serious complications.
- The physiatrist then completes the treatment plan through the treatment planning system based on the dosage prescribed by the physician.
What are the precautions after the radiofrequency knife procedure?
- Drink plenty of fluids;
- Continue to take oral antibiotics and hemostatic medications as prescribed by your doctor for 3 to 5 days orally without special circumstances;
- If symptoms such as bright red urine, blood coming out of the anal opening, fever and urinary retention occur, please seek urgent medical attention;
- Don’t take a shower on the day the “gold standard” is inserted, don’t ride a bicycle or anything like that before recovery, and avoid pressure on the prostate with physical exercise.