Stereotactic Radiosurgery

Depending on your specific case and treatment site, the following planning appointments may be needed. It’s important that you keep them all and arrive as scheduled. For all of these visits, please wear comfortable clothing.

Fiducial Placement

For treatment sites below the neck, your treatment team may need to place gold markers (fiducials) into the tumor. Through these markers, the CyberKnife system will track the tumor’s position during treatment. Your surgeon will place the markers in an outpatient area at the medical center or in the operating room. Your nurse will let you know when and where the surgeon will place your markers. For many of these procedures, you may need sedative medication to help you relax. Therefore, someone needs to drive you home afterward.

Once the surgeon has implanted your markers, the markers need to sit for at least one week before the next phases of your appointments may begin.

MRI Scan

If you have cancer involving the head, neck or spine, your care team needs to complete MRI scans as part of the treatment planning process. MRI provides your oncologist with a detailed look at the target as well as surrounding structures. MRI uses a strong magnetic field and radiowaves to make images of certain areas inside your body. MRI does not use X-rays (radiation).

Treatment Simulation

You’ll also need a CT stimulation session on the 5th floor of the Shapiro Clinical Center at BIDMC. For CyberKnife treatments involving the head or neck areas, the CT simulation therapist will position you on the CT table with a custom-fit, flexible plastic mask. For other regions of the body, the therapist may position you within a custom-fit body mold. The mask and body mold are used to keep you comfortable and still throughout your CyberKnife treatment.

The entire CT simulation session takes about two hours. Your care team uses the results of the CT simulation to plan your CyberKnife treatment.

Please keep the following in mind on CyberKnife treatment days:

• There are no restrictions on eating and drinking.
• Have someone with you and to drive you home.
• Wear comfortable clothes and leave jewelry and other valuables at home.
• The treatment itself does not cause any pain. However, it is important that you’re comfortable during treatment so you can lie still. If you take regular pain medication, be sure to take it before coming in for treatment.
• While lying on the treatment table, you’ll be fitted with your specific custom mask or body mold that the care team made during your CT simulation session.
• During treatment, the CyberKnife robotic arm will move slowly around you to deliver your treatment. The robot will not touch you.
• The amount of time the treatment takes differs for each patient. Most patients are in the CyberKnife unit for one to two hours.

Meeting with Your Radiation Therapist

Each day of CyberKnife treatment, you will meet one of our radiation therapists. The therapist delivers the prescribed treatment. The therapist will position you on the treatment table in the same posture as on the day of your CT simulation and then leave the treatment room. For the safety of family members, only the patient is allowed in the room during treatment.

Meeting with Your CyberKnife Nurse

Each treatment day, one of our nurses will check in with you and review your symptoms either before or after your treatment. A radiation oncologist also visits during the course of your treatment. A radiation oncologist is always available if you have any questions or concerns.

During Treatment

The treatment room has four cameras, a microphone and speakers. This allows the treating radiation therapist to keep full attention on you. At any time during treatment, the radiation therapist is available to answer your questions.

During treatment, you’ll see the CyberKnife's robotic arm go from one treatment position to the next. At any time, the therapist might make small adjustments of the treatment table, or come into the treatment room to make further adjustments.

Once the treatment is done that day, the radiation therapist will come into the room to help you off the table.

On the last day of your treatment, one of our nurses will discuss discharge instructions and follow-up visits with you. You’ll get a written copy of this information. The nurse can address any other questions or concerns that you or your family may have about your CyberKnife treatment.