CYBERKNIFE RADIOSURGERY FOR INOPERABLE RECURRED ORAL CANCER

사이버나이프를 이용한 수술 불가능한 재발성 구강암의 치험례

  • Kim, Yong-Kack (Department of Oral & Maxillofacial Surgery, Korea Cancer Center Hospital) ;
  • Lee, Tae-Hee (Department of Oral & Maxillofacial Surgery, Korea Cancer Center Hospital) ;
  • Kim, Chul (Department of Oral & Maxillofacial Surgery, Korea Cancer Center Hospital) ;
  • Kim, Sung-Jin (Department of Oral & Maxillofacial Surgery, Korea Cancer Center Hospital) ;
  • Kim, Hyuk (Department of Oral & Maxillofacial Surgery, Korea Cancer Center Hospital)
  • 김용각 (원자력병원 치과 구강악안면외과) ;
  • 이태희 (원자력병원 치과 구강악안면외과) ;
  • 김철 (원자력병원 치과 구강악안면외과) ;
  • 김성진 (원자력병원 치과 구강악안면외과) ;
  • 김혁 (원자력병원 치과 구강악안면외과)
  • Published : 2004.02.28

Abstract

CyberKnife is a stereotactic radiosurgery system which could be used to treat many tumors and lesions. It provides the surgeon unparalleled flexibility in targeting using a compact light linear accelerator mounted on a robotic arm. Advanced image guidance technology tracks patient and target position during treatment, ensuring accuracy without the use of an invasive head frame. CyberKnife with Dynamic Tracking Software is cleared to provide radiosurgery for lesions anywhere in the body when radiation treatment is indicated. It has often been used to radiosurgically treat otherwise untreatable tumors and malformations. Moreover, this instrument treats tumors at body sites, most of which are unreachable by other stereotactic systems. Compared with conventional radiotherapy, it is fundamentally different that using non-invasive, frameless, no excessive radiation exposure to normal tissue. In oral malignant neoplasm, surgical excision and radiation therapy should be tried first, additionally chemotherapy could be considered. However, after failure of conventional therapies, patients had poor systemic condition and surgical limitation. So, CyberKnife could be a suitable therapy. A 49 years man was referred in recurred mandibular cancer treated by radiotherapy. The tumor was considered inoperable, because of extensive invasion and was not expected to good response to conventional therapies. We experienced a case of CyberKnife after 4 cycle chemotherapies, so we report it with review of literature.

Keywords

References

  1. Takanori Ishimaru, YuzoMizugaki : CyberKnife after failed conventional therapy for oral squamous cell carcinoma: Report of 2 Patient. Asian J. of Oral and Maxillfac Surg 14:40-43,2002
  2. Ryu SI, Chang SD : Image-guided hypo-fractionated stereotactic radiosurg spinal lesions. Neurosurgery 49(4):838-46,2001
  3. 김 명진, 김 여갑, 김 용각 외: 구강암, 1판. 지성출판사, 2002, p497-583
  4. Chang SD, Murphy M : Clinical experience with image-guided robotic radiosurgery in the treatment of brain and spinal cord tumors. Neurol Md Chir 38(11):780-3,1998
  5. Chang SD, Adler JR : Robotics and radiosurgery-the CyberKnife Stereotact Funct Neurosurg 76(3-4):204-8,2001
  6. Adler JR jr, Chang SD : The CyberKnife a frameless robotic system for radiosurgy. Stereotact Funct Neurosurg 69(1-4 Pt 2):124-128,1997
  7. Mehta VK, Lee QT : Image guided stereotactic radiosurgery for lesions in proximity to the anterior visual pathways. Technol Cancer Res Treat Jun;1(3):173-80,2002
  8. Stieber VW, Bourland JD : Gentlemen, Choose your weapons: Gamma Knife vs. Linnear Accelerator radiosurgery. Technol Cancer Res Treat Apr;2(2):79-86,2003
  9. Kouji Deguchi, Tatsuya FuKuiwa : Application of CyberKnife for the treatment of juvenile nasopharyngeal angiofibroma: a case report. Auris, Nasus, Larynx 29:395-400,2002
  10. Chang SD, Main W :An analysis of the accuracy of the CyberKnife : a robotic frameless stereotactic radiosurgical system. Neurosurgery Jan;52(1):140-6,20037.
  11. Inoue T : Clinical experience of new stereotactic radiotherapy system named CyberKnife. Nippon Rinsho 59(8):1624-31,2001
  12. Shimamoto S, Inoue T : CyberKnife stereotactic irradiation for metastatic brain tumors. Radiat Med 20(6):299-304,2002