When treating cancer, there are choices to be made. Is surgery warranted? What is the role of chemotherapy? Radiation? How should these treatments be best combined? And today, CyberKnife® must be considered as an alternative treatment... or even as a primary treatment for certain types of tumors and patients. Since 1998, more than 40,000 patients all over the world have been treated with the CyberKnife stereotactic radiosurgery system. During that time, it has become a reliable, trusted modality for intracranial radiosurgery treatment and the leading modality for radiosurgery of extracranial tumors. Today, there are more than 120 CyberKnife centers worldwide, and CyberKnife is FDA-approved and reimbursable by
Medicare and most insurance carriers. So, the question isn’t whether or not CyberKnife should be considered as an alternative – or even primary – treatment for solid-mass tumors throughout the body. The question is this:

Where do you send your patients for the most informed radiosurgical care and the most precise, effective CyberKnife treatment?

At CyberKnife of Southern California at Vista, our CyberKnife system is the most advanced package available. Using the latest hardware and software, we treat tumors with greater precision, more effective doses and greater efficiency than other CyberKnife systems. Yet, what makes us Southern California’s best choice for stereotactic radiosurgery is our experience and expertise.

Our physicians introduced stereotactic radiosurgery to San Diego more than 15 years ago and, since then, have been the treating physicians for roughly 80% of all radiosurgery cases in the county, more than 2,500 in all. Our CyberKnife team includes doctors known for their knowledge, skill and contributions to radiation oncology, radiosurgery, robotic radiosurgery, neuroscience, extracranial radiosurgery and the advancement of CyberKnife as a treatment. Together, we provide radiosurgery experience and know-how unmatched in San Diego County. And when it comes to treating tumors, expertise is what matters most.

	Radiosurgery has been treating tumors with great success since the 1960s. Our physicians introduced the modality to San Diego County and have performed roughly 80% of the region’s radiosurgery procedures.
Radiotherapy irradiates tumors and surrounding tissues together over multiple sessions. Radiosurgery ablates tumors with submillimeter accuracy, sparing surrounding tissues and requiring just one to five sessions.

Radiosurgery: a proven treatment with a long history of success.

Ionized radiation has been used to treat cancer for nearly 100 years. With great success, radiation oncologists have been using radiation therapy (radiotherapy) for many decades to harm cancer cells and shrink tumors. But in the 1960s, neurosurgeons and radiation oncologists began using radiosurgery to treat intracranial tumors. Unlike radiotherapy, radiosurgery uses much higher – but much more precise – doses to shrink and destroy tumors. Throughout the past four decades, radiosurgery’s power and precision have proven highly effective as both a treatment alternative and a primary treatment for tumors. And at CyberKnife of Southern California at Vista, our radiation oncologists have been there since the beginning in San Diego County.

Our own Dr. David Hodgens was the first physician in the county to treat patients with stereotactic radiosurgery. Since then, he has treated more radiosurgery patients than any other physician in San Diego and has earned a reputation nationwide for radiosurgery excellence. Our team has since grown to include specialists with fellowship training and vast experience in radiosurgery and who have made major contributions to the field. In San Diego County, we’ve been the treating physicians for roughly 80% of all radiosurgery cases and are known as a key ingredient in radiosurgery’s success as a treatment in greater San Diego.

How do radiosurgery & radiation therapy differ?

Most radiation treatment is with radiotherapy, in which cancer cells and adjacent normal cells receive low doses of radiation. The normal cells can repair themselves. But with unstable DNA, cancer cells cannot. As a result, after as many as 40 treatments over time, the tumor shrinks and ultimately stops functioning.

Radiosurgery, on the other hand, delivers a much higher dose of radiation, which ablates the cells. In order to spare surrounding healthy tissue from exposure to this ablative dose, radiosurgery must be far more precise than radiotherapy, with accuracy that’s measured in less than a millimeter. This precision must also be maintained in three-dimensional space, meaning radiosurgery must be “stereotactic.”

Because it requires stereotaxy, radiosurgery has traditionally been limited to the treatment of intracranial tumors. A stereotactic head frame would hold the patient’s head firmly in place, eliminating movement as a concern and guaranteeing treatment delivery with the precision necessary to spare normal tissues and critical structures. Yet, this made radiosurgery a non-option for treating tumors at sites throughout the body... until now.

	CyberKnife is the first radiosurgery system to treat tumors throughout the body. It consists of a compact linear accelerator atop a highly articulated robotic arm, imaging cameras and powerful software.
CyberKnife’s radiographic cameras continually capture images during treatment. The system compares these images with pretreatment images to identify – and adjust for – a tumor’s actual location.

CyberKnife: revolutionizing the flexibility & power of radiosurgery.

Unlike other radiosurgery systems, CyberKnife continually tracks the target’s actual location and compensates for differences, with submillimeter accuracy. Two X-ray cameras confirm the target’s position prior to radiation delivery, and CyberKnife responds to any changes in position by moving its robotic arm to match. This tracking and compensation occurs with every change in angle of treatment. The result is that no frame is required to maintain stereotactic precision, which is a significant leap forward in radiosurgery.

Treating a greater variety of tumors...
with less impact on patients.

Because no frame is required, CyberKnife lets us treat tumors beyond the cranium, at sites virtually anywhere in the body, which is perhaps the most important advancement. At the same time, prep time is reduced, no anesthesia is required, treatment is comfortable and recovery time and post-treatment discomfort are usually far less than with surgery or conventional radiation therapy. Patients simply get up from the treatment table and go back to their normal activities. Also, frameless stereotaxy means the treatment can be delivered over one to five sessions, known as “hypofractionation.” While CyberKnife is accurate to less than a millimeter, its ability to hypofractionate treatment gives normal cells the chance to recover from what little radiation they do receive. This helps make CyberKnife easier on patients than other radiosurgery systems... and significantly reduces the side effects.

The next generation of the next generation in radiosurgery.

At CyberKnife of Southern California at Vista, we have the most advanced CyberKnife system available. In fact, we are the first center in the world to use the next-generation platform, which delivers 33% higher radiation output for greater efficiency and shorter treatment times. Our system’s advanced modules also let us track target positioning by referencing anatomic structures, which in many cases makes it unnecessary to implant markers, reducing prep time and eliminating an invasive (minimally) step. Soon, our system will have leading-edge beam manipulation, which is expected to increase accuracy and uniformity and further reduce treatment times. And our treatment-planning system features a platform fundamentally different from earlier systems, reducing planning time and replacing the “trialand- error” method of narrowing in on an optimized treatment plan. Ultimately, CyberKnife’s new hardware and software systems provide greater flexibility, accuracy and efficiency than other CyberKnife providers. Best of all, it’s in the hands of San Diego County’s most experienced, knowledgeable and trusted radiosurgery specialists.

	CyberKnife’s six points of axis give it total freedom of movement. This enables our physicians to treat virtually anywhere, treat from a large number of angles and freely adjust for movement of the target.		Because of CyberKnife’s revolutionary capabilities and submillimeter accuracy, our oncologists are now able to treat tumors not just in the brain and spine but also the lungs, pancreas, liver, kidneys and more.
	Our next-generation CyberKnife hardware and state-of-the-art software provide unsurpassed efficiency and accuracy. This gives our doctors the ability to treat tumors that move with respiration... while they’re moving.

An alternative way to treat a wide range of tumors.

At CyberKnife of Southern California at Vista, we’re giving your patients new reasons for hope in their fight against cancer. To begin with, CyberKnife creates treatment options that previously didn’t exist. For tumors considered medically inoperable and patients who are ineligible for surgery or chemotherapy, CyberKnife radiosurgery can serve as an outstanding alternative for the treatment of tumors of the:

Types of tumors & lesions we treat with CyberKnife:

• Malignant & benign solid-mass tumors
• Primary & metastatic tumors
• Acoustic neuroma
• Arteriovenous malformations
• Trigeminal neuralgia
• Other tumors, lesions & conditions throughout the body for which
  radiation treatment is indicated

Offering new hope for those ineligible for other radiation therapies.

In addition, our state-of-the-art CyberKnife system is an alternative firstline treatment for other types of tumors and cases that were previously untreatable with radiation, including:

• Tumors that require extremely conformal radiation treatments, which were not possible until now
• Local tumor recurrences previously treated with radiotherapy
• Situations in which there are concerns about cumulative radiation exposure
• Tumors that move with respiration

An additional tool for adjunctive – & primary – tumor treatment.

An outstanding treatment alternative, CyberKnife is also highly useful as an adjunctive therapy. We can use it in many cases in combination with conventional radiation therapy or chemotherapy to maximize treatment efficacy. We can also use it prior to surgical resection or after surgical debulking to minimize the impact of surgery.

Even in cases where surgery was historically considered the best (or only) treatment, CyberKnife often enables us to achieve outcomes that are equivalent or better. And we do it on an outpatient basis without anesthesia, incision, scarring, pain, a hospital stay, downtime or the risks associated with surgery. While some cancer surgeries have considerable risk of complication, CyberKnife generally has far fewer risks. Yet, we recognize that surgeons’ intimate knowledge of anatomical structures is vital to radiosurgical treatment. This is why we work with surgeons and encourage their involvement in the management of the patient and the planning of treatment.

	Our advanced software enables our physicians to map out the most effective treatment. Multiple delivery angles and precise dose control help achieve outcomes equal to surgery... with less risk and impact.
At CyberKnife of Southern California at Vista, our physicians are the region’s trusted radiosurgery authorities. With unmatched intraand extracranial skill, they have the expertise to achieve optimal outcomes.