Flickinger J C, Lunsford L D, Kondziolka D
Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pa.
Stereotact Funct Neurosurg. 1991;57(1-2):99-105. doi: 10.1159/000099560.
Dose-volume effects are very important in radiosurgery. Functional radiosurgery illustrates brain tolerance at the extremes of small volumes and high radiation doses. The risks of radiation necrosis from radiosurgery of arteriovenous malformations (AVMs) and tumors appear to be reasonably well predicted by the integrated logistic formula and the 1% dose-volume isoeffect line for proton beam irradiation. The two main exceptions to this rule are cranial nerves, which appear to be more sensitive than the rest of the brain, and angiographically occult vascular malformations, where complications appear to occur at lower doses/volumes than in the treatment of tumors or AVMs. Further investigation is needed to better predict complications throughout the entire range of volumes, radiation doses, treatment locations and techniques presently used in stereotactic radiosurgery.
剂量体积效应在放射外科中非常重要。功能放射外科展示了在小体积和高辐射剂量极端情况下的脑耐受性。动静脉畸形（AVM）和肿瘤放射外科治疗导致放射性坏死的风险似乎可以通过综合逻辑公式和质子束照射的1%剂量体积等效应线得到合理预测。这条规则的两个主要例外是颅神经，其似乎比大脑其他部分更敏感，以及血管造影隐匿性血管畸形，其并发症似乎在比肿瘤或AVM治疗更低的剂量/体积下发生。需要进一步研究，以更好地预测目前立体定向放射外科中使用的整个体积、辐射剂量、治疗部位和技术范围内的并发症。
