CyberKnife radiosurgery for spinal neoplasms.
CyberKnife radiosurgery for spinal neoplasms.
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射波刀放射外科治疗脊柱肿瘤。
DOI：
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发表时间：
2007
影响因子：
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通讯作者：
C. Ozhasoglu
中科院分区：
文献类型：
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作者：
P. Gerszten;S. Burton;C. Ozhasoglu
立体定向放射外科治疗颅内病变的作用已得到充分证实。由于有效的目标固定和定位技术的可用性，其用于治疗脊柱病变的用途受到限制。传统的外束放射治疗缺乏精确度，无法在脊髓等放射敏感结构附近提供大剂量的放射线。 CyberKnife（Accuray Inc.，桑尼维尔，加利福尼亚州，美国）是一种图像引导的无框架立体定向放射外科系统，可以对脊柱病变进行放射外科治疗。该系统利用一对正交 X 射线相机与动态操纵的机器人安装的轻型直线加速器的耦合，该直线加速器具有 6 d.f.无需使用基于框架的固定即可将治疗光束引导至预期目标。实时成像跟踪允许以 1 毫米的空间精度进行患者运动跟踪。颈椎病变相对于颅骨骨标志进行定位和追踪；相对于经皮放置的金基准骨标记来追踪下部脊柱病变。使用无框架图像引导系统进行脊柱立体定向放射外科手术现在既可行又安全。脊柱病变放射外科消融的主要潜在好处是门诊治疗时间短、恢复快、症状反应良好。该技术为治疗各种脊柱病变提供了一种成功的治疗方式，作为主要治疗或不适合开放手术技术的病变、无法手术的患者、位于先前照射部位的病变或作为手术的辅助治疗。
The role of stereotactic radiosurgery for the treatment of intracranial lesions is well established. Its use for the treatment of spinal lesions has been limited by the availability of effective target immobilization and localization technologies. Conventional external beam radiotherapy lacks the precision to allow delivery of large doses of radiation near radiosensitive structures such as the spinal cord. The CyberKnife (Accuray Inc., Sunnyvale, Calif., USA) is an imageguided frameless stereotactic radiosurgery system that allows for the radiosurgical treatment of spinal lesions. The system utilizes the coupling of an orthogonal pair of X-ray cameras to a dynamically manipulated robot-mounted lightweight linear accelerator which has 6 d.f. that guides the therapy beam to the intended target without the use of frame-based fixation. Realtime imaging tracking allows for patient movement tracking with 1mm spatial accuracy. Cervical spine lesions are located and tracked relative to skull bony landmarks; lower spinal lesions are tracked relative to percutaneously placed gold fiducial bone markers. Spinal stereotactic radiosurgery using a frameless image-guided system is now both feasible and safe. The major potential benefits of radiosurgical ablation of spinal lesions are short treatment time in an outpatient setting with rapid recovery and good symptomatic response. This technique offers a successful therapeutic modality for the treatment of a variety of spinal lesions as a primary treatment or for lesions not amenable to open surgical techniques, in medically inoperable patients, lesions located in previously irradiated sites, or as an adjunct to surgery.