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CyberKnife vs. Proton Therapy for Prostate Cancer

Both CyberKnife and proton beam are forms of radiation therapy; however, CyberKnife has many advantages over proton beam radiation as a prostate cancer treatment. CyberKnife is the most advanced treatment available, using image-guided robotics to destroy prostate cancer while preserving the surrounding tissue.

If you have prostate cancer and need the most innovative, non-invasive treatment, please call CyberKnife Miami today at (800) 204-0455.

Targeted Radiation without Damaging Surrounding Tissue

CyberKnife stereotactic body radiation therapy (SBRT) typically emits 150 to 200 small X-ray beams, all penetrating the prostate from multiple angles, resulting in a higher localized dose. That dose targets the exact shape of the prostate, which means a minimal dose of radiation affects surrounding healthy tissue, resulting in much fewer, if any side effects.

Faster Treatment Times

CyberKnife therapy requires only five treatments. Each treatment fraction is a much higher dose than given with proton therapy. This is called hypofractionated treatments.

Proton beams deliver a lower dose of radiation to the prostate, so many more treatments are required to a larger treatment area. These treatments use conventional fractionation with small doses given daily over a four to six week period.

Pinpoint Accuracy and Comfort

CyberKnife beams are continually image-guided throughout the entire treatment so the robot adjusts for any slight movement the patient makes.

This enables the CyberKnife beam to follow the prostate’s movement even as the patient breathes normally. If the movement is large the CyberKnife will suspend the beam until the patient is back in alignment. This allows for precise targeting of the prostate in an approximately two to five-millimeter area surrounding the prostate. 

Proton beam treatments do not have continual image-guided technology, therefore the equipment cannot make adjustments when the patient or the prostate moves, which happens naturally just by breathing. Therefore, a larger treatment area, other than just the prostate, is treated to compensate for this uncertainty. The target is usually the prostate plus 10 to 15 millimeters all around the prostate, which can result in more side effects.

Also, gas bubbles in the intestines and the bladder filling can move the prostate during treatment, sometimes up to 20 millimeters. That’s also why proton treatments rely on a bigger treatment margin to keep targeting the prostate. Since CyberKnife uses continuous image guidance to correct for any prostate motion or patient movement, it can target just the specific pinpointed area.

Evidence Based

A growing body of evidence from clinical studies using CyberKnife hypofractionated radiation treatments (high dose in five treatments) shows that CyberKnife provides more effective treatment compared to the proton beam’s conventional lower dose fractionation treatment.

A  six-year study by Dr. Alan Katz published in the Journal of Radiation Oncology confirms that using high-dose hypofractionation radiation therapy with CyberKnife is as good as or better than the prodacted low-dose conventional fractionation treatments with proton beam, and the toxicities to the bladder and rectum are lower using CyberKnife therapy. 

A more recent 10-year-study by Dr. Alan Katz, published online in the September 9, 2017 issue of Cureus, shows the efficacy and toxicity of SBRT in the treatment of low-risk prostate cancer following 10 years of treatment. All patients participating in the study were treated with the CyberKnife System and outcomes were excellent both in terms of disease control and tolerability, and were superior to long-term conventional intensity-modulated radiation therapy (IRMT).