Kassaee Alireza, Das Indra J, Tochner Zelig, Rosenthal David I
Department of Radiation Oncology, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
Int J Radiat Oncol Biol Phys. 2003 Nov 15;57(4):1192-5. doi: 10.1016/s0360-3016(03)00774-0.
A modification of a commercially available, noninvasive, relocatable, stereotactic Gill-Thomas-Cosman (GTC) head frame is presented for treatment of extracranial lesions of the head and neck, base of the skull, and inferior nasopharyngeal region.
Skull-based and nasopharyngeal lesions cannot be treated with the GTC frame because it obstructs the beam path. To treat those lesions, the GTC frame was modified without compromising the integrity, flexibility, or use of the treatment software. The modification uses a set of aluminum extension rods of variable lengths and bevels to support a modified dental plate. The extension rods allow the dental tray and attached GTC frame to be lowered so that the more inferior regions may be treated. Ten patients underwent CT with the modified frame and CT localizer. For some patients, MRI was acquired without the frame. Image fusion of MRI and CT scans was used to delineate the target volume, and planning was done with the existing software for proper treatment.
The modification of the GTC frame has been successful in imaging, planning, and extending the treatment domain for the base of the skull, nasopharyngeal regions, and other superior lesions of the head and neck. The reproducibility of the modified frame and the patient localization helmet technique was identical to that of the unmodified frame.
The modification of the GTC frame is simple and accurate. It provides flexibility in treating an extended range of the base of the skull, nasopharyngeal region, and other superior lesions of the head and neck that otherwise could not be treated with the GTC frame.
介绍一种对市售的、无创的、可重新定位的立体定向吉尔 - 托马斯 - 科斯曼（GTC）头架进行的改良，用于治疗头颈部、颅底及鼻咽下部区域的颅外病变。
基于颅骨和鼻咽部的病变无法用GTC头架治疗，因为它会阻碍射线路径。为治疗这些病变，在不损害治疗软件的完整性、灵活性或可用性的情况下对GTC头架进行了改良。改良使用了一组长度和斜角可变的铝制延长杆来支撑改良后的牙托。延长杆可使牙托及附着的GTC头架降低，从而能够治疗更低部位的区域。10例患者使用改良后的头架和CT定位器进行了CT检查。部分患者在未使用头架的情况下进行了MRI检查。利用MRI和CT扫描的图像融合来勾画靶区，并使用现有软件进行适当治疗的计划制定。
GTC头架的改良在成像、计划制定以及扩大颅底、鼻咽部区域和头颈部其他高位病变的治疗范围方面取得了成功。改良后的头架和患者定位头盔技术的可重复性与未改良的头架相同。
GTC头架的改良简单且准确。它为治疗颅底、鼻咽部区域以及头颈部其他高位病变的更大范围提供了灵活性，而这些病变原本无法用GTC头架治疗。
