The radio wave knife (Cyberknife) is also known as a stereotactic radiosurgery platform. It consists of linear gas pedal, robotic robotic arm, robot-controlled treatment bed, treatment planning system, target area positioning tracking system, respiratory tracking system, and computer network integration and control system. It adopts computerized stereotactic navigation and automatic target area tracking technology, and is a new type of large stereotactic radiotherapy equipment. Its core is interactive robot technology, the principle of which is similar to the cruise missile in national defense high-tech, real-time tracking of patient position, tumor position and patient breathing movement feedback, and real-time correction for the patient’s small movement of the target area, to truly achieve dynamic image-guided radiation therapy.
The computer-controlled, six-joint robotic arm is able to accurately irradiate up to 1920 x-ray beams in different orientations onto the lesion, while the radiation dose around the lesion decreases dramatically, greatly reducing radiation side effects and complications. The radio wave knife generally requires only 1-5 irradiations and is capable of treating multiple tumors at different sites simultaneously. It can be used for the treatment of cranio-cerebral, spinal cord, body tumors and vascular malformations, and has an irreplaceable role in the treatment of tumors in important functional areas such as skull base, intracerebral and spine, which is a major breakthrough in the field of tumor radiation therapy.
Compared with other radiotherapy devices, the indications of radio wave knife are wider, higher precision, shorter treatment course, better efficacy, local control rate of tumor can be increased from 60% to 90%, overall survival is prolonged, survival quality is significantly improved, and there are fewer adverse effects.
Indications of radio wave knife treatment
1.Tumor
(1) Tumors of the nervous system: astrocytoma, meningioma, pituitary tumor, germ cell tumor, medulloblastoma, neuroblastoma, auditory neuroma, trigeminal nerve sheath tumor, craniopharyngioma and brain metastasis, hemangioblastoma.
(2) Head and neck tumors: nasopharyngeal cancer, sinus malignancy, laryngeal cancer, oral cavity cancer, oropharyngeal cancer and hypopharyngeal cancer.
(3) Thoracic tumors: primary lung cancer, metastatic lung cancer, mediastinal lymph node metastasis and malignant tumors.
(4) Abdominal tumors: primary liver cancer, metastatic liver cancer, bile duct cancer, pancreatic cancer, kidney cancer, renal pelvis cancer, nephroblastoma, peritoneal and retroperitoneal lymph node metastasis.
(5) Pelvic tumors: prostate cancer, bladder cancer, cervical cancer, endometrial cancer, ovarian cancer.
(6) Lymphatic system tumors: Hodgkin’s lymphoma, non-Hodgkin’s lymphoma.
(7) Bone and joint tumors: osteosarcoma, Ewing sarcoma, synovial sarcoma and metastatic cancer of bone.
(8) Soft tissue tumors: liposarcoma, fibrosarcoma, smooth muscle sarcoma, rhabdomyosarcoma, angiosarcoma.
2.Vascular malformation
(1) Nervous system: cerebral arteriovenous fistula, cavernous hemangioma, spinal cord hemangioma.
(2) Other: pulmonary arteriovenous fistula, limb soft tissue hemangioma.
3.Cancer pain
2.Procedure of radio wave knife treatment
1.Expert consultation: to formulate treatment plan according to tumor site, pathological type, TNM stage, KPS score, etc.
2.Golden standard implantation: For some organs (e.g. liver, kidney, pancreas, prostate, etc.) tumors need to be implanted in advance as the tracking target.
3.Fixation of body position: Patients choose a comfortable position, head and neck are usually fixed by mask, and body is fixed by vacuum pad.
4.Precise positioning: Under the guidance of 3D digital laser localizer, digital images of the patient are obtained by using CT, MRI, PET, 3D angiography and other imaging devices.
5.Precise design: physician outlines the target area, physicist plans the design, oncologist evaluates the treatment plan and authorizes it.
6.Precise radiotherapy: the ray beam tracks the tumor in real time in multiple directions under image guidance and destroys the tumor with high precision.