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The Way It Works
CyberKnife® gives patients new hope for treating tumours that are previously diagnosed as inoperable or untreatable. As mentioned earlier, CyberKnife® uses pencil beams of radiation, which can be directed to any part of the body from any direction, through a robotic arm. The vast array of different angles/trajectories from which pencil beams of radiation converge upon the tumour lead to a high cumulative dose of radiation at the convergence point (the target/tumour), and yet a very fast ‘fall-off’ of dose towards the periphery of the carefully mapped target. The surrounding normal tissues/organs receive only a small fraction of the high central dose of the treatment.

A 53-year-old male was presented with a history of progressive pruritus and jaundice. CT scan of abdomen revealed a 6 × 5.8 cm infiltrative mass involving segment IV of liver extending to the hepatic confluence and encroaching the hepatic vessels. ERCP stenting with biliary sphincterectomy was done to relieve jaundice, and biopsy confirmed the diagnosis of Cholangiocarcinoma.

PET scan showed the presence of localised but even more extensive disease without any distant metastasis. The lesion was considered inoperable in view of the involvement of hepatic vessels. Therefore, the patient was referred for CyberKnife® treatment.

The patient was treated with CyberKnife® with 2250 cGy in five fractions and gold fiducial placement. The patient tolerated the treatment well. A CT scan performed after 6 months of CyberKnife® surgery revealed shrinkage and radiation-induced after changes without any progass of altered liver function suggesting well-being of the patient.
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