University report | June 27th, 2005

June 27th, 2005 University Clinics Munich

As from July 1st this year, a patient friendly treatment with robotics technology and precision radiation is offered in Munich: in cooperation with AOK Bayern (health insurance) and the University Clinics Munich (Neurosururgical Department and Institute of Clinical Radiology) the European Cyberknife Center-Großhadern has been established immediately adjacent to the University clinics, the first facility of its kind in Germany: in Europe there are presently four. With Cyberknife radiosurgery tumors in the head, brain, and spine are gently and effectively destroyed. For patients the Cyberknife treatment is pain-free, non-invasive, outpatient and, as a rule, is limited to one session of a few hours’ duration. Only for one day is the patient unfit for work; quality of life is not reduced and there are no costs for an inpatient hospital stay, a subsequent cure or rehabilitation measures. The estimated patient number is in the range of about 400 patients per year. The Cyberknife system is the most modern technology presently available for radiosurgical treatment. It combines digitally guided robotics technology with a high precision radiation device.

Treatable disorders
The Munich Cyberknife system has essentially been designed for the treatment of head, brain and spine/spinal cord tumors. In principle, however, tumors throughout the body can be treated with the cyberknife if the relatively rigorous indication criteria for radiosurgery are met. Treatable tumors for example should not be too large in size and they have to show distinct margins. Which disorder can be treated with the Cyberknife is decided by the responsible physicians and extensively discussed.

Radiosurgical and technical functioning of the Cyberknife
Cyberknife radiosurgery is a procedure of frameless precision radiation. In certain patients it can be used as an alternative or adjunct to open surgery or radiation therapy lasting several weeks. In this case, multiple high energy radiation from various directions is delivered from outside to a target within the body where the high concentration of radiation becomes effective and the tumour is destroyed. The single incident beam cannot cause damage, it is too weak. But the bundling of the beams in the target leads to destruction of the tumor tissue while healthy tissue in the surroundings of the tumor is not affected. The Cyberknife System is a new development in the field of radiosurgery and stereotactic radiation therapy. It combines two modern technological achievements:

- a lightweight and compact high precision radiation device (linear accelerator with 6 MeV border energy) controlled and navigated by a robot. The robotic arm can move in six degrees of freedom. Thus all parts of the body can be accessed for an optimal treatment. This system is clearly more flexible in handling and can be used for a wider range of conflicts than previous radiosurgical technology.

- a computer assisted image guidance system by which the Cyberknife can locate position of the tumour during the entire treatment, control and compensate automatically for smaller patient movements which are tolerable. Without this a compromise on precision has to be accepted. Contrary to conventional systems it is not necessary to attach a rigid frame to the head of the patient, to immobilize the body or to treat the patient under anaesthesia.

The Munich Trust of Health Care and Research
The GKV German law on modernising health care structures (GMG) of 1.1.2004 was the basis for the agreement on integrated medical care structures with the three participating partners. For the first time it was possible to formally set up the cooperation between the partners in the field of radiosurgery as had been practised already for a long time, and a solid scientific perspective for future developments in this attractive medical speciality was opened up. In this medico-scientific alliance synergetic effects from close collaboration between university departments and outpatient treatment centers are activated, which leads to a most modern and efficient treatment according to latest scientific standards, and which furthermore is orientated towards patients’ requirements and is cost effective.

In case of queries we are at your disposal:

Prof. Dr. Joerg Christian Tonn
(Head of the Neurosurgical Department, University of Munich)
Dr. A. Muacevic
PD Dr. med. Berndt Wowra
European Cyberknife Center Munich-Großhadern
Max Lebsche Platz 31, 81377 Munich/Germany
Tel.: ++49-89-452336-0, Fax: ++49-89- 4523 36-16,
e-mail:info(at)cyber-knife.net
further information:www.cyber-knife.net