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Switzerland's lifestyle and fashion magazine Annabelle report on Cyberknifehttp://translate.google.ca:80/translate?hl=en&sl=de&u=http://www.annabelle.ch/frau-krebs/news/?ne wsid=5605&ei=e7DKSav6FZGYsAO43LiwCg&sa=X&oi=translate&resnum=1&ct=result&prev=/search?q=cyberk nife&hl=en&lr=&sa=N&as_qdr=d&start=30 <The CK center in Zurich just open in March 2009> *** translated from German *** Cyber Knife - a new treatment method The Cyber Knife treatment offers new possibilities in the radio-oncology. Despite promising results are the indications for treatment, however, closely set: Only about five percent of all patients who need radiotherapy, come for the Cyber Knife in question. Christian von Briel, a specialist in radio-oncology at the Institute for radiotherapy Zurich, about the opportunities and limitations of the new device. annabelle: Christian von Briel, Radio-Oncology at the Hirslanden Clinic in Zurich, has recently been on the first and only Cyber Knife Switzerland. Will the radiation therapy is now virtually? Christian von Briel: Only in the sense, as when Cyber Knife advanced computer technology systems are in play. The Cyber Knife is a high-precision irradiation device that the robot technology serves the auto industry: The now commonly used in radiotherapy linear accelerator Linac has been reduced so much that he is on an industrial robot could be mounted. Thanks to this technique, the linear accelerator rotated in all directions, which has the advantage that the irradiation is still targeted. The robotic arm controls the individual beams from many different angles to the tumor or metastasis, thus increasing the beam in their intersection and their aufsummieren total dose unfold. This is so high that the tumor or the metastasis dies. Since the rays practically straight at its target point effect, the surrounding tissues and organs are spared. What types of tumors can be specifically with the Cyber Knife treatment? Basically, these are brain tumors, tumors in the ear, nose and throat area, lymph node metastases in the neck and the small pool, small non-operable lung and liver tumors, one lung, bone and liver metastases and tumors in the pancreas, spine, prostate, and possibly also in the cervix. Moreover, this "benign" changes will be treated as abnormalities of brain blood vessels, called arteriovenous malformation, which may often lead to brain haemorrhage, or no longer functioning nerves, such as the Trigeniusneuralgie. They speak of "small" tumors and "individual" metastases. What's up? For irradiation with the Cyber Knife, only patients in question, which a sharply limited in imaging techniques have visible tumor that is not greater than six centimeters. We can only come with the Cyber Knife treatment if they occur sporadically and cause clear symptoms. If the metastases in the body but scattered diffusely or proliferate in an organ, such as the liver, is a therapy with the Cyber Knife pointless. So are the indications for the Cyber Knife tight. Will the hopes of patients with the introduction of the Cyber Knife who are unnecessarily? In oncology, there is little or revolutions sweeping successes, but only a development in small steps, we are now able to reduce side effects of radiotherapy and reduce the number of treatments. At present it is so easy, unfortunately, that only about five percent of all patients receiving radiotherapy in need with the Cyber Knife treatment. For most types of cancer, as well as in breast cancer, the tumors are usually operated fully, and then depending Krebsherd indication preventively with conventional radiotherapy, ie with the classical linear accelerator treats. This is definitely still the best method. The Cyber Knife is thus rather a complement to conventional radiotherapy? Yes, exactly. It is a possibility that in selected cases, we can apply. Nevertheless: What can the Cyber Knife, which is the conventional radiotherapy can not? We can now broadcast in places that are usually not or only with very high risk for the patient are bestrahlbar. The best example of this is the spinal cord. Es erträgt nur eine sehr geringe Strahlendosis. It bears only a very low radiation dose. It gets too much, it will be so badly damaged that the patient is then paraplegics. For this reason, we can Wirbelkörpermetastase with a conventional linear accelerator irradiate only once. Now a metastasis grows again in the same area, thanks to the precise setting of the Cyber Knife possible that body a second time to irradiate. Now, the conventional linear accelerator Linac is already considered highly accurate. How much more precise because the Cyber Knife? We have more at Cyber Knife Einstrahlrichtungen available: While the conventional linear accelerator the tumor from four to six directions irradiate may be at Cyber Knife average of 120 different directions chosen. In theory, would be even up to 1200 Einstrahlwinkel possible that the robot with an accuracy of less than one millimeter ourselves. The quantity of the fields allows us to use higher doses because the dose due to the precise irradiation outside the tumor falls heavily. For comparison: The Linac we irradiate the patient during a conventional course of treatment from 20 to 30 days with a dose of two Gray per day. The Cyber Knife system enables us to doses from 7 to 20 Gray per day to use. This also has the consequence that the duration of treatment to one to five days. How long does a single irradiation session with the Cyber Knife? This is a very important point. In contrast to the Linac, in which the patient after a few minutes is dismissed, he must Cyber Knife at a 40 - to 90-minute duration were made about themselves and also be able to lie quietly for so long to stay. We generally do not administer anesthesia. The patient is the Cyber Knife but not helpless. Upon request, he receives a light sedative and a music program of his choice. He is meticulously monitored cameras, the robot is also stops already when he sneezes or coughs. We can treat even the short break, when the patient feels unwell or on the toilet needs. The irradiation is also completely painless. However, the patients on the couch not be fixed. Yes, that is correct. Patient pays the irradiation during a special vest, with the electrodes to bring his body movements to register. Via an image tracking system, the robot can determine its exact location of the tumor continuously locate and change the location of the patient. The system compares the real-time X-rays with CT or MRI images of the tumor, the pre-treatment were made. The coordinates are determined during the therapy to the central computer and for controlling the irradiation unit evaluated. In this way, like the Cyber Knife smaller movements of the patients. Moreover, optical sensors to monitor his breathing movements and adjust the irradiation of the respiratory rhythm. Thanks to this system, we can now also the first tumors in the lungs and abdomen accurately irradiate their position in the rhythm of respiration change. Still, one hears of serious side effects of radio-therapy. Which side effects you have after irradiations with the Cyber Knife reckon? A cancer therapy is unfortunately not without side effects, which also applies to the treatment with the Cyber Knife - even if they are delivered precisely because of the radiation are reduced. It can lead to hair loss, and about ten percent of patients suffer skin burns. By the irradiation are also Arteriosclerosis, scar formation, in small and medium-sized vessels, which are irreversible. How much scar tissue is formed, but from patient to patient is different, because the predisposition to genetically determined. What is the future of the Cyber Knife? Where us the Cyber Knife exactly lead, we will first see if we have long-term studies. But it is possible that we will the irradiation with the Linac and the Cyber Knife combine. This means that we have a larger tumor, for example, traditionally only irradiate, and then with the Cyber Knife still higher doses selectively into the rest of the tumor type. Furthermore, it is conceivable that the patient parallel to the treatment with the Cyber Knife and receives chemotherapy reduced the tumor is then surgically removed. But still we are in today, tomorrow remains to be seen. But the results so far are promising: Recently, we treated such as a sarcoma patients, one had metastasis to the spine was ingrown. He could barely walk before pain. Him, we have as one of the first patients in the clinic with the Cyber Knife irradiated. After three treatment units, it is now virtually pain free. Whether the metastasis but forever destroyed, or comes back one day, which we do not know. |
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