CyberKnife vs Gamma Knife for Brain Tumors: Which Radiation Therapy Is Better?

Over the past few decades, the treatment of brain tumors has deeply progressed, bringing options that are safer and more effective than conventional surgery. CyberKnife and Gamma Knife are two types of stereotactic radiosurgery that provide the ability to target the tumor while limiting the harm done to the surrounding healthy areas of the brain. However, this should not create confusion with a surgical intervention.

The brain tumor patient usually asks themselves which method is more effective. The answer depends on various aspects related to treatment. Each brain tumor type, size, position, and number of tumors under treatment should be considered along with the general condition of the patient.

What is CyberKnife?

CyberKnife is a unique robotic radiation therapy system that can deliver high doses of radiation with great precision. It consists of a small device with a linear accelerator mounted on the robotic arm, which serves to compensate for the patient's position throughout the therapeutic process. It will monitor the movements of both the patient and the tumor adjusting accordingly.

Unlike other conventional radiation therapies, CyberKnife does not use the cumbersome head frame in the treatment of brain tumor. The patients are fitted with a mask designed to position the head comfortably while treatment is carried out through the arm, sending radiation from many directions to the brain.

CyberKnife can be used not only for the treatment of brain tumors. Its application is also extended to treatment of tumors located in the spine, lungs, liver, pancreas, prostate, and many other areas, thus making it one of the most efficient radiation therapy systems.

What is a Gamma Knife?

Gamma Knife is a specific type of stereotactic radiosurgery that employs a specialised technique to effectively treat diseases of the brain and upper cervical spine. This type of surgery employs almost 200 gamma-ray beams directed at the target area. The procedure allows precise targeting of the affected spot because the individual beams produce a low dosage of radiation, while they work together to achieve a therapeutic effect on the tumor and healthy tissue.

Gamma Knife is known as a treatment method for several different brain conditions; these include benign tumors, malignant tumors of the brain, brain metastases, arteriovenous malformations, and some neurological diseases.

CyberKnife vs Gamma Knife: Major Differences

The main difference between the two methods lies in their treatment fields. Gamma Knife is used only for lesions found in the brain and upper neck, while CyberKnife provides therapy for tumors existing in the whole human body.

• Treatment Area: Patients prefer CyberKnife to Gamma Knife because it is much more comfortable, as it employs a customised thermoplastic mask rather than a rigid frame. Adults are comfortable with the newest technology, even without using the old frame-placement technique.
• Patient Comfort: Both treatment methods are known for their accuracy. However, while Gamma Knife has a strong reputation for treating very small lesions in the human head with very high accuracy, CyberKnife combines high accuracy with continuous image guidance.
• Precision: Gamma Knife treatment is mostly performed in one treatment session, which makes it appropriate for most low-grade brain tumors and blood vessel malformations.
• Number of Treatment Sessions: CyberKnife treatment can also be done in one session; however, according to the location, size of the tumor and the closeness of vital structures to it, treatment may be done in three to five sessions. Fractionated treatment gives healthy tissue more time to heal between radiation doses.
• Flexibility: CyberKnife offers greater flexibility because the robot can deliver the dose from multiple angles and adjust itself throughout treatment. The flexibility is particularly useful in case of non-standard tumors and other lesions near sensitive areas of the brain.

Confused Between CyberKnife and Gamma Knife?

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What kinds of brain tumors can be treated?

Both CyberKnife and Gamma Knife can handle the treatment of many types of brain tumors, which include:

• Brain metastases
• Meningioma
• Acoustic neuroma (vestibular schwannoma)
• Pituitary adenoma
• Glioma in selected cases
• Recurrent brain tumors after any previous treatment

The difference between the two technologies is mainly based on the distinguishing characteristics of the tumor rather than just its classification.

Benefits of Both Treatments

• The lack of surgical incisions in the process of treatment
• The minimum damage is done to the surrounding tissues
• Complications may be reduced
• The patients are treated without having to stay in the hospital
• The recovery process from stereotactic treatment takes a very short time or no time at all
• It is possible to treat tumors successfully in hard-to-reach places
• The hospital stay is not usually extended

Stereotactic radiosurgery is helpful for patients who are not suitable candidates for open surgery. All these advantages make it possible for many patients to choose stereotactic radiosurgery as their treatment, since it is highly effective and does not significantly disrupt daily life.

Which Radiation Therapy Is Better Suited?

There is no single answer to this question because many factors affect the decision.

Gamma Knife is usually chosen for small and well-defined tumors when accurate intracranial treatment is needed. There are multiple clinical cases confirming its effectiveness across various neurological problems.

Cyberknife may be better for this type of patient if the treatment is to be fractionated, while the patient's comfort is a significant issue, and so on.

In any case, a group of specialists in radiation therapy, surgery, and physics is needed for the proper selection.

Conclusion

CyberKnife and Gamma Knife provide two of the most modern methods of providing radiation therapy for the treatment of tumors in the brain. Both methods deliver precise radiation to the affected area while minimising the damage done to surrounding healthy tissue. Instead of worrying about which of the two methods is better overall, patient should consider which method will work best for them depending on their medical condition.

Regardless of whichever method is preferred in a particular case, a comprehensive assessment by an effective team will show which of the two methods is likely to provide maximum benefit to the patient while treating the tumor and protecting the remaining part of the brain.

Reference:

• https://pmc.ncbi.nlm.nih.gov/articles/PMC5711245/
• https://www.mayoclinic.org/tests-procedures/stereotactic-radiosurgery/about/pac-20384526