Intervenciones de enfermería con la nueva tecnología en el tratamiento del cáncer: CyberKnife / Interventions of nursing with the new technology in cancer treatment: CyberKnife

Resumen

El Cyberknife es un sistema de radiocirugía robótica sin marco de fijación, utilizado para tratar tumores benignos, tumores malignos y otras condiciones médicas. El sistema consiste en un método para administrar radiación ionizante con el acelerador lineal en forma localizada y con mayor precisión que con la radioterapia convencional. Como personal ocupacionalmente expuesto (POE), la enfermera debe ejercer todas sus funciones en los servicios y unidades donde se utilizan radiaciones ionizantes con fines médicos; por lo tanto, trabaja en estricta colaboración con el médico radiooncólogo, el físico, el dosimetrista y el técnico de radioterapia, ya que provee los cuidados específicos al paciente en la exploración y el tratamiento.

Abstract

The Cyberknife is a robotic radiosurgery system with no fixation frame, used to treat benign tumors, malignant tumors and other medical conditions. The system consists of a method for administering ionizing radiation with the linear accelerator in a localized form and with greater accuracy than with conventional radiotherapy. As an Occupationally Exposed Personnel (NPO), the nurse must perform all her functions in the services and units where medical ionizing radiation is used; therefore, it works in strict collaboration with the radiologist, the physicist, the medical dosimetrist and the radiotherapy technician, since it provides the specific care to the patient in the exploration and treatment.

Stereotactic Body Radiation Therapy for Low- to Intermediate-risk Prostate Adenocarcinoma

The aim of the present study was to evaluate the efficacy and toxicity of stereotactic body radiation therapy (SBRT) for low- to intermediate-risk prostate adenocarcinoma. Thirty-nine patients were retrospectively reviewed. The SBRT was delivered using the CyberKnife with the fiducial tracking method combined with In-tempo imaging. The gross target volume, which included the prostate only, was delineated on the fused CT/MRI scans. The prescription dose was delivered every other day as 5 fractions of 7.5 Gy. Venous blood was obtained before and after SBRT to assess the prostate-specific antigen (PSA) level. Toxicity was evaluated using the CTCAE, v4.03. The median follow-up time was 30.0 months. The median initial PSA level was 7.7 ng/mL. PSA levels decreased in all patients treated with SBRT, and after 5 months, the median PSA was less than 2 ng/mL. The rate of overall 3-yr actuarial biochemical failure free survival was 93.9%. Acute side effects were generally comparable with those of previous studies. The PSA change and toxicity after SBRT for low- to intermediate-risk prostate adenocarcinoma indicates favorable biochemical responses and tolerable levels of toxicity. Additionally short course treatment may produce cost benefit and convenience to patients.

A case report of a patient with squamous cell carcinoma of the face irradiated using a stereotactic technique

External beam radiotherapy can be used to treat cutaneous squamous cell carcinomas (SCC). Acute skin toxicity is the most common adverse event. In this case study we report on an elderly patient with nasal root cutaneous SCC treated with stereotactic technique using a dedicated linear accelerator (CyberKnife system). Grade 3 skin toxicity was observed but it was resolved after 6 weeks. The use of stereotactic radiotherapy permitted a clinical remission of SCC with good cosmetic results.

Early Therapeutic Effects of Cyberknife Radiosurgery on Trigeminal Neuralgia / 대한방사선종양학회지

PURPOSE: We evaluated whether Cyberknife radiosurgery is an effective and safe method of therapy for medically intractable trigeminal neuralgia (TN). MATERIALS AND METHODS: We retrospectively analyzed the outcome of 26 patients, who failed to surgery or were not suitable candidates for invasive intervention and were treated by Cyberknife radiosurgery between March 2004 and May 2005. Radiosurgery doses of 60~64 Gy were delivered to the 80% isodose line prescribed to an 6 mm length of the nerve, sparing the most proximal 3 mm away from the trigeminal nerve root entry zone (median dose: 64 Gy). RESULTS: Follow-up period was 3~15 months (median follow-up period: 9 months) Preliminary results from a cohort of 26 patients undergoing Cyberknife radiosurgery for TN showed that pain relief was achieved in 50% (13/26) of patients within the first 24 hrs after treatment. At last follow-up, 96.2% (25/26) of patients reported early pain relief within 7 days. Treatment failure developed in 2 of 26. Poor response occurred in one patient and relapse was observed in the other patient. 3 patients had hypoesthesia (11.5%), which was the only complication observed with any of our patients. CONCLUSION: With these results, authors assumed that Cyberknife radiosurgery for TN could be one of safe and effective therapeutic methods.