Treatment with cyber knife of malignant cancer (program ID: 251507)
European Cyberknife Centre Munich-Grosshadern
Alexander MuacevicSpecialized in: neurosurgery
- Initial presentation in the clinic
- case history collection
- general clinical examination
- laboratory tests:
- complete blood count
- general urine analysis
- biochemical analysis of blood
- TSH-basal, fT3, fT4
- tumor markers
- indicators of inflammation
- indicators blood coagulation
- CT/MRI scanners
- radiosurgical treatment by Cyber Knife
- nursing services
- services of all leading experts
- elaboration of individual treatment plan
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About the department
The Cyberknife Center at the European Cyberknife Centre Munich-Grosshadern offers the full range of special radiation therapy and radiosurgical interventions for the treatment of benign and malignant tumors. The treatment is carried out using the ultramodern Cyberknife M6 system, which is distinguished by the exceptional accuracy of tumor cell damage. The basis of clinical practice is the use of modern treatment protocols and compliance with very strict criteria for determining indications for a therapeutic procedure. The technical settings and equipment safety are monitored daily by the Section of Medical Physics. The center is headed by Prof. Dr. med. Alexander Muacevic.
The state-of-the-art Cyberknife system, which is used in the center, works on the basis of one of the most revolutionary developments of recent years in the field of surgery and oncology. A lightweight compact radiator is built into the Cyberknife system, the operation of which is controlled by a computer. The robot can move in six different directions. Thus, any organs and tissues can be subjected to high-precision irradiation. This advantage makes this system more efficient than conventional radiation therapy devices and the Gamma Knife. The image combining system allows irradiation of moving organs, such as the lungs during breathing. The second important advantage is computer-controlled image modeling. Thanks to this, the Cyberknife device can take into account the smallest movements of the patient in real time, which avoids fixing the patient during the treatment session. In addition, the operation is absolutely painless, so there is no need for anesthesia.
The Cyberknife treatment procedure consists of the following stages:
- Preparation. When treating brain tumors, before the treatment session, an individual frame is made to maintain the patient's head and provide him with comfort, and while treating tumors of the moving organs (for example, liver, lungs, heart, pancreas, etc.), preliminary marking of pathological foci is made (in collaboration with the Department of Radiology at the University Hospital of Ludwig Maximilian University of Munich).
- Preliminary diagnostics. To receive therapy, the patient needs the preliminary diagnostics, including magnetic resonance imaging or computed tomography. Computed tomography can be performed within the center (a few days before the operation or immediately before it). The MRI data obtained earlier can be processed directly in the center, on a digital medium. The special radiological tests, such as high-resolution MRI (3 Tesla MRI) and PET-CT scans, are performed in the Department of Radiology at the University Hospital of Ludwig Maximilian University of Munich.
- Treatment planning. Both CT and MRI data are transferred to a computer that conducts planning and digital simulation of the upcoming therapy. With these indicators, the doctors and medical physicists plan the amount, direction and intensity of the point radiation that the robot focuses on tumor tissue. At this stage, the presence of the patient is optional.
- Therapy session. The treatment is carried out on an outpatient basis. On the day of therapy, no special restrictions are required. The patient can eat food as usual, take medications that were prescribed earlier, etc. Before the treatment session, the patient lies on the operating table, on which a special frame for the head is fixed. The treatment is absolutely painless, so there is no need to carry out anesthesia. If desired, the patient’s favorite music can be played during the therapy session. During the procedure, it is necessary to lie calmly, trying not to make unnecessary movements. With a video camera, the doctor monitors the patient's condition, and the patient has the opportunity to communicate with the doctor through a microphone. Unlike MRI or CT scanning, the patient is located on a special table, but not inside the "capsule". As a rule, a session lasts about 45-90 minutes.
- The end of the procedure. As a rule, a single treatment session is enough. After the procedure, the patient leaves the center and returns to his normal life. In some clinical situations, the radiation dose can be distributed over several sessions and the patient visits the center several times.
- Follow-up monitoring. Once the therapy has been completed, the doctors will carry out the follow-up examinations to assess its effectiveness. The follow-up examinations are also performed on an outpatient basis.
The indications for Cyberknife treatment are the following diseases:
- Brain diseases
- Acoustic neuroma
- Arteriovenous malformations
- Brain metastases
- Trigeminal neuralgia
- Iris melanoma
- Low-grade gliomas
- Neuroendocrine tumors
- Pituitary adenoma
- Spinal cord diseases
- Spinal cord neuromas
- Spinal metastases
- Arteriovenous malformations
- Prostate diseases
- Prostate carcinomas (Gleason score of 6 and 7, PSA levels up to 15 ng/ml, patients over 60)
- Prostate cancer (metastases)
- Lung diseases
- Lung and bronchial cancer
- Lung metastases
- Liver diseases
- Primary liver cancer
- Oncological lesions of the lymph nodes
- Single metastases in the lymph nodes
- Kidney diseases
- Kidney cancer
- Upper urinary tract urothelial carcinoma
- Other diseases
Education and Professional Career
- 1989 - 1995 Study of Human Medicine, Johannes Gutenberg University Mainz.
- 1990 Grant from the Boehringer Ingelheim, Department of Pharmacology, Ridgefield, Connecticut, USA.
- 1991 - 1995 Internship in Los Angeles, Charlottesville and London, Institute of Neurology and Neurosurgery.
- 1995 Doctoral studies under the supervision of Prof. Perneczky, Mainz.
- 1996 - 2003 Junior Physician, and then Resident of the Department of Neurosurgery, University Hospital of Ludwig Maximilian University of Munich, Campus Grosshadern.
- 2005 Completion of specialized training in Radiosurgery.
- 2006 Habilitation, Ludwig Maximilian University of Munich.
- 2011 - 2013 President of the Society of Radiosurgery.
- 2013 Appointed as Professor of Ludwig Maximilian University of Munich.
- 2003 Aesculap Prize of the European Association of Neurosurgical Societies.
Membership in Professional Societies
- Since 2007 Member of the Supervisory Board of the Radiosurgery Society (RSS).
- 2011 - 2013 President of the Radiosurgery Society.
- 2014 - 2015 Chairman of the Board of Directors of the Radiosurgery Society.
- Member of the American Society for Radiation Oncology (ASTRO).
- Member of the International Stereotactic Radiosurgery Society (ISRS).
- Member of the European Association of Neurosurgeons (EANS).
- Member of the German Society for Radiation Oncology (DEGRO), Committee on Stereotactic Radiosurgery.