2.  The CyberKnife is a type radiation emitting machine used for the treatment of cancer. It emits radiation in high doses to millimeter precision. The Radiation Cancer Institute is requesting funds to purchase two new CyberKnife machines. We are presenting with a clinical study comparing the survival rate of brain metastases patients treated on a conventional 3D linear accelerators versus those treated on a Cyber Knife.

3.  The Trilogy is a linear accelerator that has the function of Image Modulated Radiation Therapy or IMRT.  Through treatment planning and then programing this type of treatment administers radiation to the shape of a tumor.  Little lead jaws conform to the programed shaped of the tumor making this treatment type 3D http://www.youtube.com/watch?v=jSgnWfbEx1A

4.  The CyberKnife is a machine that performs what is called stereotactic radiosurgery.  Radiosurgery is a non-surgical procedure that uses high precision radiation beams.  Not only do hundreds of pencil size beams deliver a high dose to the tumor, the machine takes into account movement while treating.  This ongoing imaging and machine movement to match the patients movement throughout the treatment is what makes it 4D. http://www.youtube.com/watch?v=Ktvvy_STXsc&list=PL073A23CE68CF55D7

5.  Our aim to convince investors that CyberKnife is a better machine for cancer treatment. To accomplish this we chose brain mets which is one of the most lethal and difficult cancer to treat. We have compared patients with similar primary disease then treated some on the Trilogy and others on the CyberKnife.  Patients with brain metastases have a better prognosis after treatment on a Cyber Knife than those on the Trilogy linear accelerator.

6.  After diagnosis 200 patients were chosen based on controlled and treatable disease  African American between age 30-60  Primary cancer: prostate and lung cancer

7.  Budget: The budget for this study is $ 10,020,000. The breakdown is as follows; 5 million for each machine (10 million) and 20 dollars for transportation for each patient for every follow-up (20,000).  Time table: The study is projected to be a 6 year study with treatments starting in the spring of 2014 and the last follow up in the spring of 2020.

8.  To determine which machine has the less amount of patients who have secondary metastases  To observe which machine result in the less amount of patients with recurrence  To observe which machine shrink the tumor percentage the most  To determine which machines will cure more patients

9.  One hundred patients received conventional whole brain 3D- conformal radiation therapy.  All of the patients were simulated “head first” supine and used a customized facemask.  40-50Gy, 180-200Gy a day for about 23-24weeks of treatment.  The treatment energy used was 10MV on Varian’s Trilogy machine  One hundred were treated with a Cyber Knife Robotic Radiosurgery system.  These patients were also simulated head first supine patients didn’t need to wear an aquaplast facemask  These patients were treated using between 30-40 beams with different paths and nodes for treatment.  The treatment time last about one hour for 5 days.

10.  After treatment, patients were monitored with radiological and neurological examination being done several times throughout the 12-month period.  5-year follow-up to check for recurrence  Twice a month examinations were done during months 1, 3 6, and 12  Patients had the option of getting a gas voucher card or a Metro smart trip card to accommodated them for travel expenses during the clinical study *Note: Linear accelerator: 52 patients tumor shrined by at least 10%,Cyber knife: 23 patients tumor shrined by at least 50%.

11.  Although both machines prove to increase survival time and optimize neurological function, the results from the patients treat with the cyber knife unit outweighed the patients on the conventional linear accelerator  These patients also had less skin reaction to the radiation, because the treatment days were shorter compared to the 23-24 weeks of treatment on a conventional linear accelerator