Impact of the model C and Automatic Positioning System on gamma knife radiosurgery: an evaluation in vestibular schwannomas.
Impact of the model C and Automatic Positioning System on gamma knife radiosurgery: an evaluation in vestibular schwannomas.
复制标题
C 型和自动定位系统对伽玛刀放射外科的影响：前庭神经鞘瘤的评估。
DOI：
10.3171/jns.2002.97.supplement_5.0588
复制
发表时间：
2002
影响因子：
4.1
通讯作者：
J. Peragut
中科院分区：
文献类型：
--
作者：
J. Régis;M. Hayashi;D. Porcheron;C. Delsanti;X. Muracciole;J. Peragut
对象
与C型伽玛刀相关的技术进步包括自动化系统，能够自动定位立体定向坐标。本研究的目的是分析该技术改良的临床影响。
方法
作者研究了前庭神经鞘瘤（VS）患者的样本。该样本包括使用伽玛刀放射外科治疗的三组。组I包括21例在安装自动定位系统（APS）前接受治疗的VS患者。第II组包括使用APS创建新剂量计划（换句话说，模拟剂量计划）的第I组患者。第III组为对照组，由20名肿瘤分级与前一组匹配且近期接受APS治疗的患者组成。在根据重新加载后的源的年龄校正每次发射的时间后，计算治疗时间。分析治疗时间，包括总时间、照射时间和神经外科手术持续时间。此外，还记录了剂量计划，包括等中心点数量、不同准直器数量、故障以及符合性和选择性指数。趋势是将准直器运行的平均次数从7.9次减少到1.2次，并将发射的平均次数从7.9次增加到15.6次，主要是专门使用4 mm准直器。与APS相关的一致性和选择性分别从95%提高到97%和从78%提高到84%。总治疗时间减少了53%，与患者在房间内互动所需的时间大大减少（75%），使神经外科医生在治疗期间有更大的自由来执行其他任务。神经外科医生在手术室工作的时间减少了84%。总辐射时间增加了54%。
结论
这项研究的初步结果表明，伽玛刀的自动化可能是放射外科的一个重大进步。
OBJECT
The technical advances associated with the model C gamma knife include a robotized system enabling automatic positioning of the stereotactic coordinates. The purpose of this study was to analyze the clinical impact of this technical modification.
METHODS
The authors studied a sample of patients with vestibular schwannoma (VS). This sample included three groups treated using gamma knife radiosurgery. Group I comprised 21 patients with VS treated just before the installation of the Automatic Positioning System (APS). Group II included patients in Group I with new dose plans created using the APS (in other words, simulated dose plans). Group III consisted of a control group of 20 patients matched for tumor grade with the previous group and treated recently with the APS. Treatment times were calculated after correcting the time for each shot according to the age of the sources after reloading. The treatment times, including total time, irradiation time, and duration of the neurosurgical procedure, were analyzed. In addition, dose planning including number of isocenters, number of different collimators, malfunctions, and the conformity and selectivity indices were recorded. The trend was to reduce the mean number of collimator runs from 7.9 to 1.2 and to increase the mean number of shots from 7.9 to 15.6, mostly by using the 4-mm collimator exclusively. The APS-related conformity and selectivity were improved from 95 to 97% and from 78 to 84%, respectively. The total treatment time was reduced by 53%, and time required to interact with the patient in the room was considerably reduced (75%), giving the neurosurgeon greater freedom to perform other tasks during the treatment period. The reduction of the time spent by the neurosurgeon at work in the room was 84%. The total radiation time was increased by 54%.
CONCLUSIONS
The preliminary results of this study indicate that the robotization of the gamma knife is likely a major advance in radiosurgery.