Going Live: Lessons from CyberKnife® System Installation in Melbourne

5D Clinics Melbourne successfully started treating patients with the CyberKnife System on September 3, 2025. Installation and on-site training were supported by Accuray and AlphaXRT (Accuray distributor), providing on-going support for a seamless introduction to the CyberKnife System. The onboarding process was notably rapid, thanks to the established knowledge of the CyberKnife System of the 5D Clinics Perth team. The joint venture between Icon Group (Icon) and 5D Clinics allowed the Melbourne staff to draw on over a decade of expertise from the 5D Clinics Perth team. They also provided four weeks of on-site assistance during the critical go-live phase, which proved invaluable for troubleshooting and problem-solving.

The center recruited an entirely new multidisciplinary team, none of whom had prior CyberKnife System experience. Intensive training and daily collaboration between the Melbourne and Perth teams, including morning huddles and weekly multidisciplinary meetings which helped staff quickly adapt to the new technology. Some staff travelled to 5D Clinics in Perth to receive hands-on training in order to become familiar with the treatment workflows on the CyberKnife System before going-live in Melbourne. One area that was a learning curve for the Melbourne team was the use of Synchrony real-time adaptive treatment . This is where on-site support from the Perth team really helped and supported the adoption of this advanced technology.

Remote support also played a crucial role. It is now easier than ever to connect to people remotely with the wealth of communication tools available. The Melbourne team are able to continue to collaborate with experts in Perth utilizing video calls and screen sharing for troubleshooting problems, even across great distances, all in real-time. This not only accelerated the learning curve but also fostered a culture of peer-to-peer learning, vital for the continued professional development of the staff.

One of the most significant benefits has been the exceptional level of ongoing support from AlphaXRT. They provided an on-site engineer, ensuring rapid response to technical issues and minimizing operational disruptions. Enhanced predictive monitoring of the equipment allowed for proactive maintenance, with issues flagged and resolved outside operational hours to avoid patient impact.

One of the advantages of Accuray platforms is the ease in which it allows interoperability with other systems, allowing the clinic to continue to use familiar tools or workflows that are already in place. At 5D Clinics they use two different treatment planning systems including RayStation and Accuray Precision® Treatment Planning System, although they will gradually transition all patients to be planned on RayStation in the future.

From a clinical perspective, the center has treated a wide spectrum of cases with the CyberKnife System, including brain, lung, liver, pancreas, prostate, and gastrointestinal cancers. The system’s precision and versatility have allowed the team to take on complex cases and expand their service offerings. In terms of prostate cancer the center have a great relationship with the urologists, who perform fiducial marker insertion before prostate stereotactic body radiation therapy (SBRT). And recently, the center appeared on a influential podcast and video tour, hosted by Professor Declan Murphy and the GU CAST team, demonstrating the benefits of the CyberKnife System.

The continued focus on referral pathways and building relationships between radiation oncologists and other referrers, such as urologists is promoting multidisciplinary patient-centred care. Referrals for treatment on the CyberKnife System are initiated directly by radiation oncologists; however, many referrals have also originated from patients who specifically request treatment using the CyberKnife System. Patient feedback during the early operational period has been overwhelmingly positive, with surveys reflecting high satisfaction.

The successful installation and integration of the CyberKnife System in Melbourne underscores the power of collaboration, expert support, and thoughtful planning. By partnering with experienced teams, investing in staff training, and adopting proactive maintenance practices, the center has quickly established itself as a leader in precision radiotherapy. Ongoing peer-to-peer learning, extension of treatment types and complexities and the commitment to workflow refinement will continue to drive improvements and expand the center’s capabilities.