New developments allow brain tumor specialists to pinpoint cancer cells with extreme accuracy.

Story by: Sara Thompson on June 24, 2021

TrueBeam, CyberKnife and Gamma Knife may sound like superheroes, but actually they are tools for treating brain tumors. These three machines are used for stereotactic radiosurgery (SRS), a non-surgical treatment option that uses high doses of precisely focused radiation beams to destroy cancer cells.

What is stereotactic radiosurgery (SRS)?

Older versions of radiation therapy cast a wide net of radiation around the tumor, which damages the surrounding healthy tissue. These treatments can last over a period of weeks. But new developments in SRS allow brain tumor specialists to pinpoint cancer cells with extreme accuracy. They can address tumors in less than a week in some cases, compared with the sometimes weekslong traditional radiation therapy.

Benefits of TrueBeam SRS

• Noninvasive procedures mean no need for anesthesia and lower risks than traditional surgery. Gamma Knife requires a head frame attached temporarily to the patient’s skull.
• Minimal recovery time means you can usually get back to your normal activities almost immediately.
• Patients generally have less pain and discomfort than that associated with a typical invasive surgical procedure.

SRS at Norton Healthcare Brain Tumor Center

Stereotactic radiosurgery using TrueBeam technology is available at the Norton Healthcare Brain Tumor Center, a collaboration of Norton Neuroscience Institute and Norton Cancer Institute.

The TrueBeam platform is an innovation on the much older Gamma Knife and CyberKnife platforms.

“The advantages of the TrueBeam platform include no invasive head frame like the Gamma Knife, improved tumor localization and increased particle energy compared with both Gamma Knife and CyberKnife. For the patient, that means treatment times which are up to 80% faster than either older technology,” said Aaron C. Spalding, M.D., Ph.D., a radiation oncologist and the executive medical director for Norton Cancer Institute. “We made sure that the technology available for our patients was the most advanced today. That is our commitment to our region for beyond-state-of-the art-care.”

SRS procedures on the brain involve a team of professionals from many areas, including oncologists (cancer doctors), radiation specialists, neurologists (brain doctors) and patient navigators.

“The TrueBeam has allowed our advanced team of specialists to push the envelope for faster, safer care,” said David A. Sun, M.D., Ph.D., neurosurgeon and executive medical director of Norton Neuroscience Institute.

Comparison of Gamma Knife, TrueBeam and CyberKnife

All three treat the same cancers, but they don’t all treat the same parts of the body. While the Gamma Knife can treat only brain tumors, both the TrueBeam and CyberKnife can treat tumors in the body. However, the up to two-hour treatment time of the CyberKnife means more patient discomfort.

TrueBeam and CyberKnife both have robotic-assisted surgical systems.

• Comfort for the patient can vary among these systems. TrueBeam offers a comfortable couch and no metal head frame to secure the patient’s head. Patients do not need anesthesia. TrueBeam’s onboard scanning systems help the machine correct for any movement as it tracks the tumor cells, even as the patient breathes. CyberKnife offers a similar arrangement, but with treatment times up to two hours due to the low energy photon used. Gamma Knife procedures require sedation, and the patient’s head is restrained in a metal frame.
• Treatment times vary slightly between machines. When the Gamma Knife was invented in 1967, the patient wore an invasive head frame for hours while treatment took up to an hour. Similarly, the CyberKnife’s development in 2001 meant treatment times over an hour. In part this is due to the lower photon energy of these machines. However, the TrueBeam platform with higher megavoltage photons is able to accurately deliver radiation to targets as small as 0.5 millimeters, usually in less than 15 minutes.

The TrueBeam platform can effectively simultaneously treat 20 or more brain tumors quickly. The result for the patient is targeting their brain tumors while sparing memory and speech centers, preserving quality of life.

Trust the expertise of the Brain Tumor Center

By choosing the TrueBeam platform, the Brain Tumor Center is able to fully optimize the training and skill of the medical team using the machines.

“There are many ways to achieve the results we want,” Dr. Sun said. “We use all the skills and tools at our disposal to offer the highest levels of stereotactic radiosurgery care. And that makes all the difference in the world.”