Systematic Review

Is the CyberKnife^© radiosurgery system effective and safe for patients? An umbrella review of the evidence

Medical Device Regulatory Research & Evaluation Centre, West China Hospital, Sichuan University, Chengdu, PR China

Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, PR China

‡Authors contributed equally

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Yifei Lin^‡

https://orcid.org/0000-0002-3184-9213

Medical Device Regulatory Research & Evaluation Centre, West China Hospital, Sichuan University, Chengdu, PR China

Precision Medicine Research Centre, West China Hospital, Sichuan University, Chengdu, PR China

‡Authors contributed equally

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Youlin Long

Medical Device Regulatory Research & Evaluation Centre, West China Hospital, Sichuan University, Chengdu, PR China

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Liang Du

Medical Device Regulatory Research & Evaluation Centre, West China Hospital, Sichuan University, Chengdu, PR China

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Rui Chen

School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, PR China

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Tengyue Hu

West China School of Medicine, Sichuan University, Chengdu, PR China

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Qiong Guo

Medical Device Regulatory Research & Evaluation Centre, West China Hospital, Sichuan University, Chengdu, PR China

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Ga Liao

*Author for correspondence: Tel.: +86 028 8542 1915;

E-mail Address: liaoga.scu@qq.com

State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China

Medical Big Data Centre, Sichuan University, Chengdu, PR China

Department of Information Management, Department of Stomatology Informatics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China

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Jin Huang

**Author for correspondence: Tel.: +86 028 8542 1915;

E-mail Address: michael_huangjin@163.com

https://orcid.org/0000-0001-7160-2314

Medical Device Regulatory Research & Evaluation Centre, West China Hospital, Sichuan University, Chengdu, PR China

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Published Online:9 Feb 2022https://doi.org/10.2217/fon-2021-0844

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Abstract

Background: The CyberKnife^© system combines real-time image guidance and a dynamic tracking system to implement frameless radiotherapy. This umbrella review is aimed to evaluate the effectiveness and safety of CyberKnife. Methods: A comprehensive search of health technology assessments and systematic reviews was performed among the Embase, PubMed and other grey databases until July 2020. Treatment outcomes were extracted, and the quality of included studies were assessed using AMSTAR-2. Results: Nineteen studies were eligible. CyberKnife not only had a wide range of applications, long overall survival and great local control, but also had a limited toxicity and good cost–effectiveness compared with other radiotherapy equipment. Conclusion: Despite the relatively low quality of the evidence, our findings can still provide a decision reference for policymakers.

Plain language summary

An umbrella review on the effectiveness and safety of the CyberKnife^© system was performed by comprehensively searching for all related publications. The CyberKnife system had excellent effect on treatment of cancer and some noncancer diseases, with limited toxicity. Additionally, it was a cost-effective treatment compared with other types of radiotherapy. Despite the relatively low quality of the included evidence, our findings can still provide a comprehensive decision reference for policymakers of patients, government and hospitals.

Keywords:

Papers of special note have been highlighted as: • of interest

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Vol. 18, No. 14

Supplemental Materials

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History

Received 7 July 2021

Accepted 28 January 2022

Published online 9 February 2022

Published in print May 2022

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Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.futuremedicine.com/doi/suppl/10.2217/fon-2021-0844

Author contributions

C Yifan: conceptualization, data curation, formal analysis, investigation, methodology, writing – original draft. L Yifei: conceptualization, investigation, methodology, project administration, supervision, writing – original draft. L Youlin: conceptualization, data curation, formal analysis, investigation, methodology, writing – original draft. D Liang: conceptualization, formal analysis, methodology, supervision. C Rui: formal analysis, investigation, project administration. H Tengyue: conceptualization, data curation, investigation. G Qiong: conceptualization, data curation, visualization. L Ga: conceptualization, funding acquisition, methodology, project administration, resources, supervision, writing – review and editing. H Jin: conceptualization, funding acquisition, methodology, project administration, resources, supervision, writing – review and editing.

Financial & competing interests disclosure

This work was supported by the National Health Commission of the People's Republic of China (grant no. 2017-S-0009-4-4); the Key Program of Sichuan Provincial Science and Technology Department, China (grant no. 2019YFS0194); the National Key R&D Program of China (grant no. 2020YFC2003405); and the National Natural Science Foundation of China (grant no. 72074161, 81873197, 81403276). The role of the funder: The funder did not take part in the study design, data search, data extraction and data analysis or in writing this report. The funder was not involved in making the decision to submit the manuscript for publication. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Data sharing statement

The data used to support the findings of this study are included within the article.

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Is the CyberKnife© radiosurgery system effective and safe for patients? An umbrella review of the evidence

Abstract

Plain language summary

References

Is the CyberKnife^© radiosurgery system effective and safe for patients? An umbrella review of the evidence