Pediatric CyberKnife Stereotactic Radiosurgery

What is CyberKnife stereotactic radiosurgery?

Despite its name, radiosurgery isn’t a true surgical procedure. Doctors don’t use a knife or scalpel. Instead, stereotactic radiosurgery uses targeted beams of radiation (high-energy X-rays called photons) to treat a problem. These beams go through skin and bone to try to destroy a tumor. There are no incisions (surgical cuts).

By delivering smaller amounts of radiation over several days with CyberKnife treatment, we minimize the risk of exposing surrounding healthy organs and tissue to harmful radiation.

What conditions does CyberKnife treat?

Our doctors use the latest CyberKnife radiation therapy to treat:

• Arteriovenous fistulas (AVFs)
• Arteriovenous malformations (AVMs)
• Cancerous brain tumors like medulloblastoma, pilocytic astrocytomas and anaplastic astrocytomas
• Certain types of epilepsy or seizure disorders
• Noncancerous brain tumors like craniopharyngiomas and pituitary lesions
• Neck tumors
• Spine tumors like ependymomas

What are the benefits of CyberKnife stereotactic radiosurgery?

CyberKnife offers an effective way to treat tumors and vascular problems without using traditional surgery. Radiation beams travel through skin and bone to hit a specific area. With this approach, we’re able to protect more healthy tissue from damaging radiation.

CyberKnife radiosurgery is an outpatient procedure, which means your child goes home the same day. Other benefits of CyberKnife radiation include:

• Noninvasive brain surgery: With traditional brain surgery, surgeons remove a piece of the skull to access the brain. This increases the risk of complications like blood loss, infection, tissue damage and pain. Because CyberKnife doesn’t require opening up the skull and exposing the brain, there’s little, if any, risk of infection. Your child shouldn’t have pain and there’s no loss of blood.
• Minimal damage to healthy tissue: Standard radiation therapy is less targeted than CyberKnife. This means it can scatter radioactive beams in the body, which can harm healthy tissue. CyberKnife delivers precise radiation that only hits the tumor or treatment site, without scattering radiation and harming healthy tissue.
• Fast recovery: Unless your doctor says otherwise, your child can resume all regular activities after each treatment session.
• Hope for complex conditions: Some of our research focuses on using CyberKnife to treat large AVMs (abnormal tangles of arteries and veins in the brain). This is a new way to treat large vascular problems in the brain that other doctors may deem untreatable. We have neurosurgeons who only work with children who have AVMs or other vascular abnormalities. They have deep expertise and years of experience treating these conditions.

What are the side effects or risks of CyberKnife stereotactic radiosurgery?

There are risks with any procedure involving the brain. Radiosurgery carries fewer side effects and risks because it doesn’t involve surgery. Radiosurgery’s rare side effects include:

• Brain cyst
• Brain swelling
• Headache
• Hemorrhagic stroke
• Seizures

What are Children’s Health’s outcome metrics for CyberKnife stereotactic radiosurgery?

Our doctors have decades of experience using stereotactic radiosurgery techniques to help children. We’re actively involved in research to improve techniques and treatment results. We’ve had great success using CyberKnife on children of all ages, even infants younger than a year old.

What should you expect with CyberKnife stereotactic radiosurgery?

Although CyberKnife radiosurgery is painless, your child will receive anesthesia and be asleep during the procedure. It’s important that your child remain still so the radiation beams can hit their target.

During the procedure:

• Your child wears a soft, custom-fitted face or body mask. This mask keeps your child’s body still and in the correct position during treatment.
• Your child’s doctor controls a device called a linear accelerator that’s mounted to a robotic arm. The doctor guides the device as it moves around your child delivering treatment.
• This device uses real-time images to aim and deliver radiation. Your child’s doctor is able to rotate the robotic arm to treat areas that a human hand can’t reach.

The linear device monitors your child’s movements (including breathing) and tracks the treatment site. It makes adjustments as needed before delivering radiation.

Depending on the problem, each CyberKnife treatment may take between 30 minutes and 2 hours. You should plan to be at the treatment center all day for presurgical preparations and postsurgical recovery time.

What should you expect after CyberKnife radiosurgery?

Your child can go home the same day of the procedure and resume normal activities within 24 hours of treatment. Children rarely experience pain or discomfort.

It can take weeks, sometimes months, for treatment effects to be noticeable. Some vascular problems like AVMs may take up to three years to completely go away. Your child will get frequent imaging scans like MRIs to check their condition.

Our Brain Tumor Treatment Program provides follow-up care for children with brain tumors.

What questions should I ask my provider about CyberKnife stereotactic radiosurgery?

It’s important that you feel confident making this treatment decision for your child. Don’t hesitate to ask questions that help you understand the procedure, including why your child needs it. You might want to ask your child’s doctors these questions:

• How many CyberKnife procedures have you performed for my child’s specific condition?
• What were the procedure outcomes?
• What outcome should I expect for my child?
• Are there other treatment options for my child’s condition?
• How soon will I be able to see my child after treatment?
• How soon after treatment can my child go home?
• What should I expect during my child’s recovery?
• What signs of complications should I look out for?