Sinai Hospital, through the Alvin & Lois Lapidus Cancer Institute and the  Department of Radiation Oncology, has established a stereotactic radiosurgery center, using the Accuray CyberKnife�.

Mark Brenner, M.D., chief of Radiation Oncology, and Neal Naff, M.D., chief of Neurosurgery, are directing the center.

Patient treatment began in April 2003. The facility and staff continue to provide this exciting new therapy option to our patients.

For more information or to make a referral to the CyberKnife� Center, contact the Radiation Oncology department at Sinai Hospital at 410-601-9786.

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What is stereotactic radiosurgery? What is the difference between conventional radiation therapy and stereotactic radiosurgery? What is the difference between CyberKnife� and other stereotactic radiosurgery systems? What can CyberKnife� treat? What is the treatment course? What are patient benefits? Support Groups and Organizations Our CyberKnife Team of Experts Abstracts Presented at the CyberKnife Annual User's Meeting The Sinai CyberKnife Experience

What is stereotactic radiosurgery?

Stereotactic radiosurgery is a non-surgical treatment using very focused beams of radiation on small and previously inaccessible tumors or lesions deep within the body. Because the radiation beams enter the body from many different angles and all focus directly on the tumor or lesion, the surrounding healthy cells and important structures (blood vessels, nerves, etc.) are spared.

What is the difference between conventional radiation therapy and stereotactic radiosurgery?

Conventional radiation therapy (radiotherapy) administers a broad beam of radiation from one or two directions through normal tissues and requires between 10 and 20 treatments to complete. Stereotactic radiosurgery delivers highly focused beams from many directions so that the normal tissues experience less radiation and the treatment can be completed in only one to three sessions.

What is the difference between CyberKnife� and other stereotactic radiosurgery systems?

• The CyberKnife�, like other stereotactic radiosurgery systems, uses a linear accelerator (beam source) and image guidance. In addition, the CyberKnife� utilizes a robotic arm that gives the system flexibility to reach areas of the body that are unreachable by other radiosurgery systems.
• The CyberKnife� system is able to locate tumors within the body without the use of an invasive stereotactic headframe used with other systems. This is much more convenient and less traumatic for patients.
• The CyberKnife� system is able to compensate for patient movement during treatment, ensuring accurate targeting of the radiation source to the site of the tumor/lesion. 

What can CyberKnife� treat?

The following tumors, lesions and conditions can be treated with the CyberKnife� Stereotactic Radiosurgery Program (not all-inclusive):

• Cancers involving the brain
• Lung cancers
• Pancreatic cancers
• Cancers involving the spine
• Benign brain tumors, such as acoustic neuromas, meningiomas, pituitary adenomas, craniopharngiomal hemangioblastoma, schwannomas
• Malformations of blood vessels within the brain, such as arteriovenous malformations (AVMs)
• Trigeminal neuralgia
• Metastatic orbital tumors, orbital lymphomas and orbital inflammations. 
  
• Prostate cancers
• Kidney cancers

What is the treatment course?

CyberKnife� treatment is performed on an outpatient basis. The patient receives an initial consultation with the radiation oncologist and surgeon.  A CT scan (3-D X-ray) is obtained. The 3-D image obtained is used by the physicians, physicists and team to create a treatment plan. The patient will return for the one-hour treatment within a few days after the consultation. The number of treatments will vary depending on tumor size, location and shape, but the number of treatments is usually between one and four.

What are patient benefits?

• Better quality of life during and after treatment
• Head frames not used as with other stereotactic radiosurgery programs
• Performed on an outpatient basis
• Less pain
• No incisions
• Risk is minimized to healthy tissue surrounding tumor/lesions
• Fewer visits to the hospital
• Short recovery period
• Treatment is available for tumors considered inoperable by other surgery and stereotactic radiosurgery methods
• Lower risk of complications when compared to other treatment options
• Lower risk of infections
• Lower risk of hemorrhage/severe blood loss
• Lower risk of hearing loss
• Lower risk to alteration in feeling of extremities
• Treatment planning scans can be scheduled at the patient�s convenience, up to day(s) before the treatment 

Patient Referrals and Additional Information

For more information or to make a referral to the CyberKnife� Center, contact the Radiation Oncology department at Sinai Hospital at 410-601-9786.

Support Groups and Organizations

The American Brain Tumor Association
http://www.abta.org

American Cancer Society
http://www.cancer.org

The Acoustic Neuroma Association
http://www.anausa.org

The Brain Tumor Society
http://www.tbts.org

CyberKnife Society
http://www.cksociety.org

International Radiosurgery Support Association
http://www.irsa.org

Accuray
http://www.accuray.com 

CyberKnife Patient Support Group
www.cyberknifesupport.org

Our CyberKnife� Center Team of Experts

Radiation Oncology
Mark Brenner, M.D., Chief, Department of Radiation Oncology
Cardella Coleman, M.D., Department of Radiation Oncology
Wendla K. Citron, M.D., Department of Radiation Oncology

Neurosurgery - Brain lesions and Spinal Tumors
Neal Naff, M.D., Chief, Department of Neurosurgery
Hatem Abdo, M.D., Neurosurgery
Hugo Benalcazar, M.D., Neurosurgery
Joseph Ciacci, M.D., Neurosurgery
John Caruso, M.D., Neurosurgery
Zeena Dorai, M.D., Neurosurgery
Brian Iuliano, M.D., Neurosurgery
Agha Khan, M.D., Neurosurgery

Orthopedic Surgery - Spinal Tumors
Alan Levine, M.D., Medical Director, Alvin & Lois Lapidus Cancer Institute, Orthopedic Surgeon
Albert Aboulafia, M.D., Orthopedic Surgeon

Surgical Oncology - Pancreas, Liver Tumors
Mukund Didolkar, M.D., Director, Surgical Oncology
Kyo Chu., M.D., Surgical Oncology  

Thoracic Surgery - Lung Tumors
Lynne Skaryak, M.D., Head, Divison of Thoracic Surgery
Paul Chomiak, M.D., Thoracic Surgeon
Laurie Reeder, M.D., Thoracic Surgeon

Gynecologic Oncology 
Fouad Abbas, M.D., Gynecology Surgeon

Ophthalmology - Eye/Orbit lesions
Mark Hirschbein, M.D.,Ophthalmologist

Urology
Bruce Berger, M.D., Urologist
Keith O'Reilly, M.D., Urologist

Abstracts Presented at the CyberKnife Annual User's Meeting

Results of Stereotactic Radiosurgery (CyberKnife�) in Unresectable and Locally Recurrent Adenocarcinoma of the Pancreas.
Click here for the PDF

Surgical Wound Complications in Patients Treated with CyberKnife Stereotactic Radiosurgery for Tumors of the Spine
Click here for the PDF

The Sinai CyberKnife Experience:

Total cases treated: 862
Brain: 339
Spine: 158
Lung: 146
Pancreas: 50
Other Non-CNS cases: 153

We are ranked in the top:
25 worldwide and 15 US for IC
10 worldwide and 10 US for Spine
5 worldwide and 5 US for Lung
5 worldwide and 5 US for Liver

There are approximately 60 US sites and 32 sites International.