Gammaknife v. Cyberknife

Portal Forums Lung/Thoracic Cancer Stereotactic Radiation Gammaknife v. Cyberknife

This topic contains 7 replies, has 8 voices, and was last updated by  treatmentadvice 5 years, 3 months ago.

Viewing 8 posts - 1 through 8 (of 8 total)
Author Posts   
Author Posts
February 18, 2013 at 12:05 pm  #1253923    


I know that both of these are forms of SRS therapy, but I’m curious as to whether one is any better than the other in treating brain mets. From what I have found, it appears that some hospitals offer cyberknife and others offer gammaknife, and I am sure that those institutions would recommend the therapies that they have available but I’m curious as to whether there is any objective evidence that one has advantages over the other.

February 18, 2013 at 1:59 pm  #1253941    

laya d.

Hi tjames:

While waiting for the docs and moderators to come onboard, I thought I’d send you this link of a prior discussion in this regard (including valuable insight from Dr. Loiselle – – our radiation oncologist here at GRACE:

My understanding of gamma knife v. cyber knife is that they are very similar technologies…and, as you said, a particular institution’s preference usually is the technology that they have.

When my Mom was treating, her primary oncologist was at the City of Hope (about an hour from my Mom’s home). When she initially developed a brain met and required post-surgery radiation treatment to the surgical bed (from which the brain met was extracted), I contacted her Radiation Oncologist at the City of Hope and asked if he thought it would be a good idea for us to transfer her from the local hospial where she was admitted – – and which had a gamma knife machine – – to the City of Hope where they have a tomo machine (and no gamma knife machine). My Mom’s Radiation Oncologist told me that the technologies for the purposes of my Mom’s treatment were very similar- – and that in all honesty, he did not think that she would get an added benefit if she was transferred from the local hospital to City of Hope. And, my Mom, in fact, never had a recurrence of disease in that particular area of her brain after undergoing gamma knife.

Anyway, just wanted to share our experience with you.


1/10 – My Mom (58) dx w/ NSCLC-Adeno 3a; 1 cycle of neoadjuvent Carbo/Alimta before finding out EGFR+ (Ex. 19), then switched to 7 wks of neoadjuvent Tarceva/150 mg (major shrinkage); 4/10 – right pneumonectomy; 6/10 started 3 rounds of adjuvent Cis/Alimta w/ concurrent chest radiation (7 wks); 8/10 – NED; 11/10 – small nodule in left lung; 1/11 – 3 small nodules in left lung, start Tarceva/100 mg; 4/11 – suspected sclerotic met to hip, continue w/ Tarceva, add XGEVA, brain MRI clear; 9/11 – solitary 3 cm met (adeno w/ T790m mutation) to cerebellum, surgery and gamma knife, up Tarceva to 150 mg; 11/11 – 2 left lung nodules growing, biopsy on 1 shows mutation from adeno to squamous (shocker!), brain MRI clear, continue Tarceva & Xgeva; 2/12 – brain MRI clear, CT scan, remaining nodule slightly bigger – – monitor for now, Tarceva (reduced to 100 mg) & Xgeva continued; 4/12 progression and rebiopsy (confirmed adeno), stop Tarceva, switch to Carbo/Alimta; 6/12 maintenanceAlimta; 8/12 back to Tarceva; 10/12 Gemzar; 11/16 difficulty breathing; 12/12 hospice initiated…my Mom passed away peacefully on 12/19/12. Heartbroken.

February 18, 2013 at 2:01 pm  #1253942    
catdander forum moderator
catdander forum moderator

tjames, It is my understanding that there is no evidence that they are different. They are made by different companies and have different sales pitches.

Dr. West stated, ” To my knowledge, there are no studies that actually compare these different techniques. I think they differ more in marketing than actual outcomes. My medical advice would be to not get too caught up in the hype, which would imply that there is actually some meaningful difference in how various branded SRS techniques differ. There is no evidence that shows this to be the case.” in this very detailed discussion on the subject,


February 18, 2013 at 7:31 pm  #1253955    
Dr West
Dr West

I still feel that way and am nearly completely certain that the only differences that are conveyed have no basis in medical evidence and are much more based on market forces. They’re both perfectly capable of doing the same job, even if there are minor differences. If you needed a taxi to the airport right away and a Toyota pulled up, you wouldn’t generally tell them to go ahead and wait for a different model because you only want a Ford. There might be a difference between a Toyota, Honda, and Ford (pick the car of your choice here), but they’ll all serve your immediate needs the same and get you to the airport just as well.

-Dr. West

February 20, 2013 at 2:35 pm  #1254023    

Dr. Weiss

I like Dr. West’s analogy so much I might start copying it. And, I strongly agree. The different forms of SRS are far, far, far, more similar than they are different. They all focus radiation in a very similar way and with similar efficacy.

February 20, 2013 at 2:52 pm  #1254029    

certain spring

I had never come across either of these terms until I started reading posts on GRACE. In the UK we generally just call it “radiotherapy” or “SRS” (stereotactic radiotherapy”).I find the “knife” part very odd – as if this were some sort of surgery.
tjames, for what it’s worth, I’ve had radiation at two different hospitals, and what mattered to me was the ethos of the department. One was calm and ordered, the other rather haphazard (which did not inspire confidence). So those are the criteria I would use.

49-year-old non-smoker, dx stage IV NSCLC May 2010 (squamous tumour of the left lung with multiple brain metastases). Radiotherapy to chest and brain; progressed through two cycles carbo/gemcitabine. Repeated lung collapses; pneumonia in collapsed lung, Nov 2010; bronchial stent placed, Dec 2010. Declined second-line Taxotere. Mutation testing Feb 2011, surprise EGFR exon deletion 19. Started Tarceva (150mg), Feb 2011. Progression in liver and elsewhere, May 2013.

February 25, 2013 at 5:43 am  #1254171    


Gamma Knife and CyberKnife are equal in out comes. Gamma Knife uses cobalt radiation and CyberKnife uses high dose xray beam radiation (using a small linear accelerator). The differences are that Cyberknife can treat tumors anywhere in the body and Gamma Knife cannot. Gamma Knife uses a head frame that is bolted into the skull with screws and is limited to a single fraction while CyberKnife uses a thermoplastic mask to hold the head in position and therefore can allow for more than one fraction. Typically one to five fractions are used. More fractions are used if the tumor is large or if it is in close proximity to critical structures like the brainstem or optic nerve.

Cyberknife is used to treat brain, spine, lung, liver, prostate, and pancreas since 2003. It uses realtime imaging of the target and respitory tracking to treat organs that move with respiration. No other radiation therapy has this capability.

February 25, 2013 at 10:02 am  #1254183    


For Acoustic Neuroma’s Dr John Kresl, Nationally Recognized Radiation Oncologist in Phoenix Arizona, was involved in a comparison of Gamma Knife VS. Cyberknife (for Acoustic Neuroma). Because Cyberknife does not use the bolt on head frame, it can deliver the radiation in the same massive dose Gamma Knife does, or treat over 1 to 5 fractions. The study showed the lower dose treatment had the same success in ablating the AN, but had much higher success of preserving the patients hearing. The large dose of the Gamma Knife showed a lot of patients losing their hearing, in comparison to Cyberknife. They are both pin-point, sub-millimeter accuracy treatments.

Viewing 8 posts - 1 through 8 (of 8 total)

You must be logged in to reply to this topic.