Step 5: Treatment Planning

Treatment planning is the process through which physicians and the medical physicist plan the details of radiation delivery. During the CyberKnife treatment planning process, the physician/physicist determines the volume and dose of radiation, and uses a computer to help determine the best radiation delivery plan.

Patients are scheduled for a planning session (pre-treatment) prior to receiving a CyberKnife treatment. If the condition being treated is for a brain tumor or lesion, we will make a custom molded face mesh that will help you hold still during your treatment session(s). This mesh device is fitted to your face quickly and the process is quite painless. The mesh mask is allowed to dry and will be ready for the patient’s use on the first day of treatment. During the planning stage, the patient may receive a CT and/or MRI. These images are then used to plan the treatment target and dose. After the images, the patient can return home until the day of the treatment.

If the condition being treated is not intracranial, but elsewhere in the body, special markers may need to be placed in the body. These markers are called fiducials, and they help the CyberKnife physicians localize the treatment area. Fiducials can be implanted by the patient’s physician, often in an outpatient medical center, and normally do not require hospitalization. Fiducials are very small pellets and can remain in the body permanently without harm.

Each patient receives an individualized treatment plan and treatments are specific to the condition being targeted. Consequently treatment times may vary. Some patients require additional treatments depending on the size and location of their lesion. Fractionated treatments are usually short and are typically given in two to five sessions over a period of days.