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CyberKnife Stereotactic Radiosurgery A Revolutionary Treatment with Sub-Millimeter Accuracy www.ChicagoCK.com A new paradigm in full body radiosurgery, the CyberKnife system leads the field with groundbreaking technology. Many tumors, even when immobilized, have proven to shift during treatment delivery. Using advanced robotic technology and continual image guidance, the CyberKnife system delivers unprecedented targeting accuracy with the unique ability to automatically correct for intra-fraction target motion – without interrupting the treatment or having to reposition the patient. Unconstrained by the clockwise/counter-clockwise gantry rotations of con- ventional radiotherapy systems, the robotic mobility of the CyberKnife system delivers automated non-coplanar treatments without clinician intervention or treatment interruption. This capability efficiently enables unrivaled conformality and dose gradient for treating even the most complex targets. Without the limitations of conventional respiratory gating and breath-holding techniques, the CyberKnife system delivers beams that move precisely with tumor motion throughout the respiratory cycle. By dramatically reducing the planning margins to only that which are clinically relevant, the CyberKnife system has proven to provide unparalleled healthy tissue preservation.

Intensity Modulated Radiation Therapy The Newest Technology in the Fight Against Cancer Intensity modulated radiation therapy, or IMRT, is a state-of-the-art technology that delivers radiation with extraordinary accuracy. Different from most forms of radiation therapy, IMRT is a dynamic and highly automated process for delivering individualized radiation treatment. With a computer-controlled delivery system, the radiation is shaped to the exact contours of the targeted area. The computer manages the precise amount and intensity of radiation delivered. Rather than a wide radiation beam, IMRT delivers thousands of extremely thin focused beams of radiation entering the body from many angles, with precision. IMRT offers the opportunity for safer, more effective treatment with reduced complications. Because of its precision, it gives physicians the ability to target tumors with a higher dose of radiation. This unique delivery also protects healthy tissue and any surrounding organs, which means less damage, and therefore fewer side effects and a higher probability to cure some tumors. IMRT has been used to treat a wide range of cancers. For some patients, IMRT replaces other types of radiation therapy; for others, it may be most effectively used in conjunction with or after another treatment. IMRT can be particularly effective in treating tumors in areas where adjacent organs and tissue are especially sensitive to damage by radiation. IMRT is well suited for hard-to-reach tumors located very close to delicate organs such as the eye or spinal cord.

3-D Conformal Radiation Therapy An Innovative Option for Enhanced Control and Better Results 3-D conformal radiation therapy, or 3D-CRT, is a very precise technique for irradiating cancerous tissues while sparing nearby healthy tissues. 3D-CRT uses a detailed 3-dimensional “map” of the patient to plan and deliver the treatment. The intensive planning that is part of 3D-CRT makes targeting the radiation much more accurate than with conventional external beam radiation therapy. Planning begins by acquiring a detailed 3-dimensional image of the patient in exactly the same position that will be used for treatment. This requires careful positioning of the patient and use of an immobilization device to ensure that the alignment is reproducible from day to day. As in conventional radiation therapy, radiation treatment is spread out over time so that healthy tissues can repair. Treatment therefore consists of short outpatient sessions typically given each weekday for up to eight weeks in all. The added precision of 3-D conformal therapy makes it a good choice for treating hard-to-reach tumors or for tumors located near organs and tissues sensitive to radiation. It can be an excellent option for any patient with localized tumors, and is particularly useful in treating patients who have already received radiation treatment and experience recurrent tumors in the treated area.

Brachytherapy A Proven Technique for Highly Controlled Treatment Brachytherapy is a form of radiation therapy that works in short distances within the body. It is a treatment where small seeds, tubes, needles, or wires of radioactive material is placed, permanently or temporarily, inside the body. This lets the radiation directly reach its target area without having to pass through layers of healthy tissues. Because the radiation is emitted outward from a concentrated source within or very near a tumor—rather than passing through normal tissue—this therapy precisely targets cancerous growths. Brachytherapy is the most accurate way to deliver radiation to certain organs and tissues. By delivering a higher dose of radiation directly to the tumor, the dose to surrounding organs and other tissue is reduced. It has a greater impact on the tumor with far fewer side effects and other complications for patients. Some implants are even done on an outpatient basis, allowing the patient to go home immediately following treatment. Successfully used for a wide range of cancers, brachytherapy can be an effective option in situations where surgery is not possible or desirable, or where dose- limiting external beam therapy has already been given. It can also be used to deliver a planned extra dose of radiation directly to the tumor after a series of external radiation treatments.

External Beam Radiation Therapy A Time-Tested Treatment for a Wide Range of Needs The most common form of radiation therapy, external beam radiation therapy uses penetrating beams of high-energy radiation waves to stop the growth of cancer cells. Sometimes called radiotherapy, irradiation, or x-ray therapy, this type of ionizing radiation is much more powerful than non- ionizing radiation such as sunlight, radio and microwaves. A machine, such as a linear accelerator, directs these beams from outside the body through normal tissue to reach the cancer. The benefit to this form of therapy is the brief high doses of radiation, which can be very effective in destroying cancer cells. It is a non-surgical, outpatient procedure and therefore requires no anesthesia. The brief sessions minimize exposure to healthy cells, and the time in between allows cells to recover. Because normal tissues receive radiation, side effects are common and vary in length. Many different cancers can be successfully treated with external beam radiation therapy. It may be used alone or in combination with chemotherapy, surgery, or both.