Radiosurgery for Tumors in the Body: Clinical Experience Using a New Method
Radiosurgery for Tumors in the Body: Clinical Experience Using a New Method
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体内肿瘤的放射外科治疗：使用新方法的临床经验
DOI：
10.1023/b:jora.0000010880.40483.c4
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
A. Tilikidis
中科院分区：
文献类型：
--
作者：
H. Blomgren;I. Lax;H. Göranson;Thomas Kræpelien;B. Nilsson;I. Näslund;R. Svanström;A. Tilikidis
一种立体定向体框架，用于精确定位肿瘤，可重复固定，并使用加速器（放射外科）进行高剂量部分照射。在这个机体框架的帮助下，肿瘤通常用5到9束静态共面或非共面光束治疗，产生计划的不均匀剂量分布，肿瘤中心的剂量比计划靶体积的周围高50%。由于剂量梯度很大，周围的正常组织暴露于相对较低的剂量。在50例常规治疗方式已用尽或被认为不适用的患者中，75例可评估的肿瘤接受了15至45 Gy（平均28 Gy）剂量的治疗，在计划靶体积的外围按一至五部分（平均2.5 Gy）进行治疗。肿瘤体积在2-732 cm3之间（平均73 cm3），主要是肝脏、肺和腹膜后间隙的各种原发转移灶。一些原发性如肺癌和原发性肝癌也得到了治疗。在1.5-38个月（平均11个月）的评估期间，通过ct检查判断22例肿瘤生长停止（29.3%），29例肿瘤体积缩小（38.7%），24例肿瘤消失（32%），通常在放疗后2- 3个月间隔进行ct检查。4例肿瘤归为局部失败（5.3%）。这种无创、无痛、快速且不需要住院治疗的治疗方法，如果使用得当，不会损害患者的生活质量。不论病人的年龄和医疗状况如何，都给予治疗。
A stereotactic body frame for exact tumor localization, reproducible fixation, and high-dose fraction irradiation with an accelerator (radiosurgery) has been developed. With the aid of this body frame, tumors are usually treated with five to nine static coplanar or noncoplanar beams yielding a planned inhomogeneous dose distribution with a 50% higher dose in the center of the tumor compared to the periphery of the planning target volume. Due to the steep dose gradient, the surrounding normal tissue is exposed to relatively low doses. Seventy-five evaluable tumors in 50 patients in whom conventional treatment modalities had been exhausted or considered inapplicable have been treated with doses of between 15 and 45 Gy (mean, 28 Gy) at the periphery of the planning target volume delivered in one to five fractions (mean, 2.5). The tumors, which had volumes ranging from 2–732 cm3 (mean, 73 cm3), were mainly metastases, from a variety of primaries, in the liver, lungs, and retroperitoneal space. Some primaries such as lung cancer and primary liver cancer were also treated. During an evaluation period of 1.5–38 months (mean, 11 months) 22 tumors showed growth arrest (29.3%), 29 were reduced in size (38.7%), and 24 disappeared (32%) as judged by computed tomography examinations, which were usually performed at 2- to 3-month intervals after radiosurgery. Four of the tumors were classified as local failures (5.3%). This treatment, which is noninvasive, painless, and rapid and does not require hospitalization, does not impair the quality of life of the patients when used properly. Treatment has been given regardless of age and medical status of the patients.