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Dissecting The CyberKnife: Is It Really Such A Big Deal?

 KUTRRH Chairperson Prof Olive Mugenda speaks after the hospital commenced CyberKnife services. [Courtesy]

When the Kenyatta University Teaching, Referral and Research Hospital (KUTRRH) launched the CyberKnife System last May, the institution claimed to have made history by acquiring the device, which they said was the first and only fully robotic radiotherapy device for cancer treatment. 

On Wednesday, the institution announced that it had made another medical milestone after treating its first patient for CyberKnife surgery.

Speaking after witnessing the first treatment, KUTRRH Chairperson Prof Olive Mugenda said the journey to commissioning the machine was "a major milestone for the hospital and Kenya."

"As part of the strategic plan, for the last few years, we have harboured the need to move into high-precision treatment. KUTRRH finally managed to acquire the machine, which is a bold but best decision for Kenya in efforts to decrease outbound medical tourism and increase inbound medical tourism," said Mugenda.

Following the announcement, there was a lot of curiosity as Kenyans sought to understand what this meant for them. What exactly is the CyberKnife? What does it treat? Is it really a game-changer in Kenya's medical history?

The Health & Science team embarked on a mission to answer some of these questions. 

Understanding cancer treatments

The effects of cancer treatment can be physically and emotionally taxing, especially when treatment damages healthy cells, as in the case of chemotherapy and conventional radiation therapy. 

In conventional surgical treatment of cancer, surrounding healthy tissue has to be removed making recovery time painful or longer for the patient. In some cases, entire organs have to be removed, completely altering the life of the patient who now has to live without the organ.

In some instances, a cancer patient has an otherwise inoperable or surgically complex tumour. Without special technology that can make treatment more precise and less invasive, the treatment options become limited.

One treatment option that meets this delicate balance is radiosurgery as it minimises radiation exposure to healthy tissue surrounding the tumor. There are various forms of radiosurgery. However, one form of radiosurgery is very precise; stereotactic radiosurgery.   KUTRRH Chairperson Prof Olive Mugenda being taken through how the CyberKnife System works. [Courtesy]

Stereotactic radiosurgery, according to the University of Washington Medical Centre (UW Medicine), is a very precise form of therapeutic radiation that can be used to treat abnormalities in the brain and spine, including cancer, epilepsy, trigeminal neuralgia and arteriovenous malformations. 

It may also be called stereotactic body radiation therapy (SBRT) or stereotactic ablative radiotherapy (SABR) when used outside the central nervous system (CNS).

This is not to be confused with stereotactic radiotherapy. The difference between the two has to do with the intensity and duration of the radiation treatments. Stereotactic radiosurgery delivers radiation at a very high intensity, all at once, to a small area while stereotactic radiotherapy delivers radiation at different times, at lower intensities and to larger areas.

While stereotactic radiotherapy has the ability to easily treat very large tumour volumes by treating over time during cell division, stereotactic radiosurgery treats brain disorders with a precise delivery of a single high dose of radiation in a one-day session.

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While radiosurgery is a more precise and less invasive treatment than radiotherapy, it is limited to the head and neck since these areas can be immobilised to completely restrict the head's movement, permitting the most precise and accurate treatment.

Radiosurgery administers a higher-intensity dose of radiation and is not used to treat areas of the body other than the head because there is no way to immobilise the body to treat a tumor in one session.

However, according to UW Medicine, stereotactic radiotherapy, which administers lower-intensity doses of radiation during a period of days or weeks, may be administered in the body with the assistance of removable masks and frames that achieve some degree of lesser mobilisation.

Radiotherapy is one of the most widely used therapies for cancer treatment, according to the International Atomic Energy Agency. It consists of using radiation in its different forms (X-rays, Gamma rays, particles) to harm and destroy tumours, either alone or in combination with surgery or chemotherapy. 

According to the US National Cancer Institute, there are two types of radiation therapy: external beam radiation (teletherapy, given by an external radiation source at a distance from the body) and internal radiation therapy (brachytherapy). 

Brachytherapy is a cancer treatment in which radioactive material sealed inside a seed, pellet, wire, or capsule is implanted in the body using a needle or catheter. The radiation given off by this source damages the DNA of nearby cancer cells. Brachytherapy is most commonly used to treat prostate cancer but can also be used to treat cancers of the head and neck, breast, cervix, and eye.

When cancer treatment is prescribed for a patient, a radiation oncologist makes decisions regarding the type of system that is best suited to treat that specific cancer patient.

As we had mentioned before, stereotactic radiotherapy, which is an external radiation therapy, involves focusing the radiation beam on a small area and delivering very high doses.  KUTRRH's CyberKnife System. [Courtesy]

CyberKnife or Gamma Knife?

In radiotherapy, two treatment options stand out; Gamma Knife, which, according to our research online, is available in various health facilities in Kenya; and CyberKnife, which was launched this year at KUTTRH. 

Gamma Knife and CyberKnife are not actual knives as the name might suggest but machines that deliver forms of radiation therapy. Both are registered trademarks.

The Gamma Knife trademark belongs to Elekta Group, which produces today's Gamma Knife based on a prototype developed in 1967 by Lars Leksell, a Swedish physician and professor of neurosurgery.

The CyberKnife trademark belongs to Accuray Incorporated in the United States. It was invented by John Adler, an American neurosurgeon and his colleagues at Stanford Health Care, Stanford University in the USA in 1994. 

Both treatments use focused beams of high radiation to tumours with precision. The Summit Cancer Centre (SCC) in the US summarises the Gamma Knife approach as delivering multiple,  beams of radioactive cobalt applied simultaneously to the target area or tumour location.

The CyberKnife system, on the other hand, applies a single, high-energy photon beam directly to the exact target area, according to SCC. This means it combines stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) giving it an advantage over the Gamma Knife because tumours in the whole body can be treated and is not limited to the skull and the cervical spine.

The CyberKnife allows patients to lie comfortably on the procedure table without anaesthesia while the robotic arm moves, without touching them, to treat all areas of the tumour. Unlike the Gamma Knife, which might need local anaesthesia, no anaesthesia is administered to patients using the CyberKnife. 

The CyberKnife machine has a robotic arm that is able to move around the patient, accessing the tumor from different angles which increases the number of positions that it can administer radiation to the treatment area. This also minimises the dose to healthy tissue surrounding the treatment area.

According to Ruth Wambui Manyangi, the CyberKnife manager at KUTTRH says CyberKnife not only has the advantage of mobility, but it offers more precision because it is image-guided. 

"When you're treating a tumour, you always want to hit the target. This machine can take an image say after every 10 seconds or 1 minute which gives the exact position of the organs," she says.

Dr Tracy Irura, a Radiation Oncologist explains that the CyberKnife's precision comes from its ability to track, detect and correct for tumor and patient movement throughout thetreatment thanks to its 6D tracking system.

"It is able to follow every movement with sub-millimetre accuracy. The robotic arm is able to shoot beam lens from all the six dimensions," she says.

Our conclusion? CyberKnife may or may not be the only precise treatment (with sub-millimeter accuracy) available for cancer. However, it is a precise and non-invasive treatment that can offer more options.

The CyberKnife System at KUTTRH is definitely a first in medical facilities in Kenya and Sub-Saharan Africa.

Cyberknife Global Market Report 2023

Major players in the cyberknife market are Accuracy, IBA Group, Mitsubishi Electric, Hitachi America, Sumitomo Heavy Industries, Nucletron B.V., Elekta AB, GE Healthcare, Varian Medical Systems, RaySearch, BrainLab, Nordion, Modus Medical Devices, Toshiba Medical Systems Corporation, and ShenZhen Gene MDx Biotech Co.

New York, July 25, 2023 (GLOBE NEWSWIRE) -- Reportlinker.Com announces the release of the report "Cyberknife Global Market Report 2023" - https://www.Reportlinker.Com/p06480014/?Utm_source=GNWLtd.

The global cyberknife market is expected to grow from $0.46 billion in 2022 to $0.55 billion in 2023 at a compound annual growth rate (CAGR) of 18%. The Russia-Ukraine war disrupted the chances of global economic recovery from the COVID-19 pandemic, at least in the short term. The war between these two countries has led to economic sanctions on multiple countries, a surge in commodity prices, and supply chain disruptions, causing inflation across goods and services and affecting many markets across the globe. The cyberknife market is expected to reach $1 billion in 2027 at a CAGR of 16.46%.

The cyberknife market consists of sales of robotic linac, robotic manipulator, image guidance system, image tracking system.Values in this market are 'factory gate' values, that is the value of goods sold by the manufacturers or creators of the goods, whether to other entities (including downstream manufacturers, wholesalers, distributors and retailers) or directly to end customers.

The value of goods in this market includes related services sold by the creators of the goods.

The CyberKnife System is a non-invasive treatment for malignant and non-cancerous tumors and other disorders where radiation therapy is recommended. This allows for smaller treatment margins around the tumor, minimizing the amount of healthy tissue exposed to a high radiation dose.

North America was the largest region in the cyberknife market in 2022. The regions covered in cyberknife report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East and Africa.

The main types of cyberknife are linear accelerator-based and standalone cyberknife.Linear accelerator-based cyberknife refers to a cyberknife system that uses a linear accelerator (linac) installed directly on a robot to deliver the high-energy photons or X-rays required in radiation therapy.

A linear accelerator-based cyberknife device is used to deliver high-energy X-rays or photons used in radiation therapy. The cyberknife systems are used for treating tumors, cancer, vascular malformation, and others in hospitals, clinics, ambulatory surgical centers, radiotherapy centers, and others.

The increasing incidence of cancer is expected to propel the growth of the cyberknife market going forward.Cancer is a severe disorder in which the body's cells reproduce fast and uncontrollably, resulting in abnormal growth.

Cyberknife is approved for treating a variety of cancers and is a non-invasive, non-surgical, pain-free treatment option where radiation therapy is indicated.The ongoing research and development activities to improve the cyberKnife system and expand its applications to other medical conditions are also expected to contribute to the growth of the market.

For instance, in September 2020, according to the report released by the National Cancer Institute, a US-based government agency, a projected 1,806,590 new cancer cases were identified in the US, while 606,520 people passed away from the illness. 1,730 cancer-related deaths and 16,850 new cancer diagnoses among kids and teenagers aged 0 to 19 are projected for 2020. By 2040, it's anticipated that there will be 29.5 million new instances of cancer each year, and 16.4 million people will die from cancer. Further, according to a report by the American Cancer Society, the estimated number of new cancer Cases in 2021 was 1,898,160, which increased to 1,918,030 in 2022 Therefore, the increasing incidence of cancer is driving the growth of the cyberknife market.

Product innovations are a key trend gaining popularity in the cyberknife market.Major market players are concentrating their efforts on creating newer products, such as the development of improved imaging and treatment planning software and the development of new and enhanced accessories and peripherals, such as immobilization devices, respiratory gating systems, and other tools that help to improve the accuracy and precision of cyberknife treatments.

For instance, in June 2020, Accuracy, a US-based medical equipment manufacturing company, launched CyberKnife® S7™ System.It is a robotic, non-invasive radiation therapy device that can deliver all stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) treatments in as little as 15 minutes.

This device combines speed, advanced precision, and real-time artificial intelligence (AI)-driven motion tracking and synchronization treatment delivery.

In September 2022, Standard Imaging, a US-based manufacturer of quality assurance solutions in radiation therapy, acquired Integrated Medical Technologies (IMT) for an undisclosed amount.This acquisition enables to better serve IMT customers by bringing together complementary solutions, expanding our bespoke production capabilities, and expanding IMT market segments in tissue equivalent dosimetry phantoms.

Integrated Medical Technologies (IMT) is a US-based provider of radiation therapy and medical imaging phantoms for radiotherapy and diagnostics.

The countries covered in the cyberknife market report are Australia, Brazil, China, France, Germany, India, Indonesia, Japan, Russia, South Korea, UK, USA.

The market value is defined as the revenues that enterprises gain from the sale of goods and/or services within the specified market and geography through sales, grants, or donations in terms of the currency (in USD unless otherwise specified).

The revenues for a specified geography are consumption values that are revenues generated by organizations in the specified geography within the market, irrespective of where they are produced. It does not include revenues from resales along the supply chain, either further along the supply chain or as part of other products.

The cyberknife market research report is one of a series of new reports that provides cyberknife market statistics, including cyberknife industry global market size, regional shares, competitors with a cyberknife market share, detailed cyberknife market segments, market trends, and opportunities, and any further data you may need to thrive in the cyberknife industry. This cyberknife market research report delivers a complete perspective of everything you need, with an in-depth analysis of the current and future scenarios of the industry.Read the full report: https://www.Reportlinker.Com/p06480014/?Utm_source=GNW

About ReportlinkerReportLinker is an award-winning market research solution. Reportlinker finds and organizes the latest industry data so you get all the market research you need - instantly, in one place.

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CONTACT: Clare: clare@reportlinker.Com US: (339)-368-6001 Intl: +1 339-368-6001

Kamiyacho Neurosurgical Clinic In Japan Celebrates First Brain Tumor Patient Treated With The New ZAP-X® Gyroscopic Radiosurgery® Platform

SAN CARLOS, Calif.--(BUSINESS WIRE)--Oct 24, 2023--

ZAP Surgical, a leading innovator in the field of surgical robotics, today announced the first patient treatment using the groundbreaking ZAP-X® Gyroscopic Radiosurgery® platform at Kamiyacho Neurosurgical Clinic in Tokyo, Japan. The event took place on October 19th, marking a significant milestone in the field of neurosurgical care and cancer treatment. Kamiyacho Neurosurgical Clinic, located on the 2nd floor of the Tokyo World Gate Tower, is the second healthcare facility in Japan to introduce the ZAP-X platform.

This press release features multimedia. View the full release here: https://www.Businesswire.Com/news/home/20231019369649/en/

The front reception at Kamiyacho Neurosurgical Clinic, showcasing the ZAP-X platform with floor to ceiling windows. (Photo: Business Wire)

The Tokyo World Gate Tower, situated in the vibrant business district of Tokyo, offers an added layer of convenience for patients, not only in the city but for those from all over Japan. The tower's strategic location is directly connected to the subway station and houses various hotels and company offices.

As a completely non-invasive outpatient treatment for select brain tumors and other cranial indications, stereotactic radiosurgery (SRS) is a proven alternative to historical surgical procedures. Unlike surgery, however, the SRS procedure requires no incisions and is painless. In most cases, patients immediately return to normal activities following SRS.

The ZAP-X system stands out with its innovative design, employing distinct gyroscopic mobility to guide radiosurgical beams from hundreds of unique angles, and ensuring precise radiation concentration on the tumor target. This innovative method aligns with the clinical goal of safeguarding the patient's healthy brain tissue and maintaining cognitive function.

Additionally, the vault-free ZAP-X system is well-known for its ability to eliminate the high costs associated with constructing shielded radiation treatment rooms. This self-shielding feature successfully cleared the rigorous Japanese nuclear regulations, which are known to be among the most stringent in the world. The ZAP-X also eliminates the necessity of managing, securing, and frequently replacing live radioactive isotopes used in historical radiation beam production.

Combined, these ZAP-X innovations allow for newfound siting flexibility, and consequently bring world-class SRS to locations previously considered infeasible.

Dr. Ryutaro Nomura, Neurosurgeon and Director of Kamiyacho Neurosurgical Clinic, expressed his enthusiasm, stating, "It is impossible to install other radiosurgery devices into such a small clinic in an office building in the Tokyo city center. The ZAP-X's compact and innovative design has made it possible for us to bring state-of-the-art radiosurgery treatment to our patients in this unique urban outpatient setting."

Eight additional patients are already booked for ZAP-X treatment later in October, underscoring the clinic's commitment to offering cutting-edge care to patients across Japan.

About ZAP Surgical Systems, Inc.

ZAP Surgical Systems, Inc. Designs and manufactures the ZAP-X® Gyroscopic Radiosurgery® platform. ZAP was founded in 2014 by Dr. John R. Adler. In addition to being CEO of ZAP, Dr. Adler is Emeritus Dorothy & TK Chan Professor of Neurosurgery and Radiation Oncology at Stanford University. Dr. Adler is also renowned as the inventor of the CyberKnife ® system and founder of Accuray, Inc. The ZAP-X platform incorporates a unique vault-free design that typically eliminates the need for costly shielded treatment rooms. ZAP-X also utilizes a modern linear accelerator to eliminate legacy use of Cobalt-60. Learn more at ZAP Surgical and follow us on LinkedIn.

View source version on businesswire.Com:https://www.Businesswire.Com/news/home/20231019369649/en/

CONTACT: Mark Arnold, ZAP Surgical Systems, Inc.

Senior Vice President, Marketing

+1 650 492 7797, ext. 101

Email:info@zapsurgical.Com

KEYWORD: UNITED STATES JAPAN NORTH AMERICA ASIA PACIFIC CALIFORNIA

INDUSTRY KEYWORD: RADIOLOGY SURGERY ONCOLOGY HEALTH MEDICAL DEVICES HOSPITALS HEALTH TECHNOLOGY OTHER HEALTH

SOURCE: ZAP Surgical Systems, Inc.

Copyright Business Wire 2023.

PUB: 10/24/2023 05:00 AM/DISC: 10/24/2023 05:01 AM

http://www.Businesswire.Com/news/home/20231019369649/en

Copyright Business Wire 2023.

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