Is it More Helpful or Harmful? Evaluating the Impact of Cyberknife Radiosurgery on Pain Elimination
One important area of research for the Cyberknife system is the study of its impact on improving pain after treatment. As previous assignments have suggested, the Cyberknife holistically shows promise as a precise and effective alternative treatment method for people suffering from various types of cancer. What has not been explored as in depth is the impact of the Cyberknife system on pain post-treatment. Though the device may be able to shrink tumors and kill off cancer very precisely, a person’s quality of life (QOL) may not be very good if he or she is still experiencing pain after treatment. The objective of this paper was to evaluate the impact of the Cyberknife on pain elimination for cancer patients.
Past literature has indicated that the Cyberknife is capable of maintaining quality of life post-treatment. But within the realm of QOL exists the experience of pain. Research related to pain treatment has predominantly been conducted for patients battling cancers of the nervous system. Few articles have been published exploring this. For example, two research articles have been reported stating that although QOL was not significantly effected for cancer patients with spinal lesions, the Cyberknife system did significantly improve patient pain post-treatment (Degan et al., 2005; Gagnon et al., 2009). Additional research has reported similar findings. For example, in a 10 patient sample undergoing Cyberknife treatment for trigeminal neuralgia, 7 of the patients experienced pain relief (Romanelli et al., 2003). In a study evaluating Cyberknife treatment for 41 patients with trigeminal neuralgia, 36 patients (~88%) reported excellent pain control, 2 reported moderate, and 3 reported no change in pain at a median of 1week post treatment (Lim et al., 2005). Recurrence of pain was experienced in 6 patients 6 months post treatment (Lim et al., 2005), suggesting that the pain relief for this patient sample was immediate but then returned shortly after treatment (Lim et al., 2005). Similar findings were reported in research conducted by Singh on trigeminal neuralgia treatment; a majority of patients experienced immediate pain relief (Singh et al., 2016). Lastly, in research evaluating the treatment of the Cyberknife on atypical trigeminal neuralgia, 4 out of 7 patients experienced immediate pain relief, 2 had minimal relief, and 1 reported no change (Patil et al., 2007).
Figure 1: Kaplan-Meier curve for TN1 patients. 28 out of the initial 125 TN1 patients performed follow-ups of greater than 1 year post treatment. 82% of patients low pain scores one year after treatment. 11 patients had follow-ups of greater than two years after treatment; 72% reported lower pain scores 2 years post-treatment. Out of 5 patients performing the 3-year post treatment survey, 40% experienced total symptom relief. (Singh et al., 2016).
Overall, the literature in this field suggests that the Cyberknife system has an immediate positive impact on reducing pain, specifically for those suffering from cancers of the nervous system.
References
Degen, J. W., Gagnon, G. J., Voyadzis, J., Mcrae, D. A., Lunsden, M., Dieterich, S., Henderson, F. C. (2005). CyberKnife stereotactic radiosurgical treatment of spinal tumors for pain control and quality of life [Abstract]. Journal of Neurosurgery: Spine, 2(5), 540-549.
Gagnon, G. J., Nasr, N. M., Liao, J. J., Molzahn, I., Marsh, D., Mcrae, D., & Henderson, F. C. (2009). Treatment Of Spinal Tumors Using Cyberknife Fractionated Stereotactic Radiosurgery [Abstract]. Neurosurgery, 64(2), 297-307.
Lim, M., Villavicencio, A., Burneikiene, S., Chang, S., & Adler, J. (n.d.). CyberKnife radiosurgery for idiopathic trigeminal neuralgia. Neurosurg Focus, 18(5), 1-7.
Patil, C. G., Veeravagu, A., Bower, R. S., Li, G., Chang, S. D., Lim, M., & Adler, J. R. (2007). CyberKnife radiosurgical rhizotomy for the treatment of atypical trigeminal nerve pain [Abstract]. Neurosurgical FOCUS, 23(6).
Romanelli, P., Heit, G., Ching, S., Pham, C., & Adler, J. (2003). Cyberknife Radiosurgery for Trigeminal Neuralgia [Abstract]. Karger, 81.
Singh, R., Davis, J., & Sharma, S. (2016). Stereotactic Radiosurgery for Trigeminal Neuralgia: A Retrospective Multi-Institutional Examination of Treatment Outcomes. Cureus, 8(4).
