Gerszten Peter C, Ozhasoglu Cihat, Burton Steven A, Vogel William, Atkins Barbara, Kalnicki Shalom, Welch William C
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Stereotact Funct Neurosurg. 2003;81(1-4):84-9. doi: 10.1159/000075109.
This study evaluated the CyberKnife frameless image-guided radiosurgery system for the treatment of spinal lesions.
This system utilizes the coupling of an orthogonal pair of X-ray cameras to a dynamically manipulated robot-mounted linear accelerator that guides the therapy beam to the intended target without the use of frame-based fixation. Cervical spine lesions are located and tracked relative to skull bony landmarks; lower spinal lesions are tracked relative to fiducial markers. 125 spinal lesions in 115 consecutive patients were treated with a single-fraction radiosurgery technique.
Tumor volume ranged from 0.3 to 232 ml (mean 27.8 ml). Tumor radiation dose was maintained at 12-20 Gy to the 80% isodose line (mean 14 Gy); the spinal cord or canal volume receiving greater than 8 Gy ranged from 0.0 to 1.7 ml (mean 0.2 ml). No acute radiation toxicity or new neurological deficits occurred during the follow-up period (3-24 months).
The CyberKnife system was found to be feasible, safe and effective. The major potential benefits of radiosurgical ablation of spinal lesions are short treatment time in an outpatient setting with rapid recovery and good response.
本研究评估了射波刀无框架图像引导放射外科系统用于治疗脊柱病变的效果。
该系统利用一对正交的X射线摄像机与一个动态操纵的机器人安装式直线加速器相结合，在不使用基于框架的固定装置的情况下将治疗束引导至预定目标。颈椎病变相对于颅骨骨性标志进行定位和跟踪；下脊柱病变相对于基准标记进行跟踪。对115例连续患者的125个脊柱病变采用单次分割放射外科技术进行治疗。
肿瘤体积范围为0.3至232毫升（平均27.8毫升）。肿瘤辐射剂量维持在12 - 20 Gy至80%等剂量线（平均14 Gy）；接受大于8 Gy的脊髓或椎管体积范围为0.0至1.7毫升（平均0.2毫升）。在随访期（3 - 24个月）内未发生急性放射毒性或新的神经功能缺损。
发现射波刀系统是可行、安全且有效的。脊柱病变放射外科消融的主要潜在益处是门诊治疗时间短、恢复快且反应良好。
