Stereotactic radiosurgery of the brain using the first United States 201 cobalt-60 source gamma knife.
Stereotactic radiosurgery of the brain using the first United States 201 cobalt-60 source gamma knife.
复制标题
脑部立体定向放射外科使用美国第一台201钴60源伽马刀。
作者：
L. Lunsford;J. Flickinger;G. Lindner;A. Maitz
1987 年 8 月 14 日，美国第一台用于脑肿瘤和动静脉畸形立体定向放射外科手术的 201 钴 60 源伽马刀在匹兹堡大学投入使用。在第一次放射外科手术之前，经过四年半的密集规划、监管机构审查和对已发表结果的分析。这个 18,000 公斤重的装置的安装和 201 个钴 60 源的装载给工程、建筑和放射物理学带来了重大挑战。手术前4个月，我们收治了52例患者（动静脉畸形29例，颅底轴外肿瘤19例，轴内恶性肿瘤4例）。大多数患者要么有被认为“无法手术”的病灶，要么在尝试手术切除后仍有残留病灶。手术死亡率和显着发病率均与伽玛刀放射外科手术无关。与传统颅内手术（开颅手术）治疗相比，放射外科手术的平均住院时间缩短4至14天，住院费用降低高达65%。根据之前公布的全球 2,000 多名患者的治疗结果以及我们的初步临床经验，我们相信，在某些病例中，伽马刀立体定向放射外科手术是一种治疗有效且经济合理的替代方案，可以替代更传统的神经外科手术。
The first United States 201 cobalt-60 source gamma knife for stereotactic radiosurgery of brain tumors and arteriovenous malformations became operational at the University of Pittsburgh on August 14, 1987. Four and one-half years of intensive planning, regulatory agency review, and analysis of published results preceded the first radiosurgical procedure. Installation of this 18,000-kg device and loading of the 201 cobalt-60 sources posed major challenges in engineering, architecture, and radiophysics. In the first 4 months of operation, we treated 52 patients (29 with arteriovenous malformations, 19 with extra-axial neoplasms of the skull base, and 4 with intra-axial malignant tumors). Most patients either had lesions considered "inoperable" or had residual lesions after attempted surgical resection. Neither surgical mortality nor significant morbidity was associated with gamma knife radiosurgery. As compared with treatment by conventional intracranial surgery (craniotomy), the average length of stay for radiosurgery was reduced by 4 to 14 days, and hospital charges were reduced by as much as 65%. Based on both the previously published results of treatment of more than 2,000 patients worldwide and on our initial clinical experience, we believe that gamma knife stereotactic radiosurgery is a therapeutically effective and economically sound alternative to more conventional neurosurgical procedures, in selected cases.