Niranjan Ajay, Novotny Josef, Bhatnagar Jagdish, Flickinger John C, Kondziolka Douglas, Lunsford L Dade
Department of Neurological Surgery, University of Pittsburgh, and Center for Image-Guided Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Stereotact Funct Neurosurg. 2009;87(3):191-8. doi: 10.1159/000222663. Epub 2009 Jun 3.
We analyzed the efficiency of the Leksell Gamma Knife Perfexion (LGK PFX) in the treatment of multiple metastases and benign tumors. We also compared treatment planning conformity between LGK PFX and LGK 4C for benign tumors.
Over a 6-week interval, 37 patients (21 with multiple brain metastases and 16 with benign tumors) underwent radiosurgery using LGK PFX at the University of Pittsburgh. We created dose plans for all patients using Leksell Gamma Plan for LGK PFX and LGK 4C. The same doses were prescribed for both LGK PFX and LGK 4C.
No significant difference was observed between LGK 4C and LGK PFX for total beam-on time. The median reduction in setup time on the LGK PFX was 53 min per patient (range 19-125 min) for multiple metastases. The median reduction in setup time on the LGK PFX for benign tumors was 16 min per patient (range 5-53 min). There was no significant difference in the dose conformality between LGK 4C and LGK PFX.
This study demonstrated that in addition to its enhanced cranial reach, LGK PFX provided a significant improvement in efficiency for patients with multiple brain metastases. For benign tumor radiosurgery LGK PFX provided improvement in efficiency without a significant difference in conformality.
我们分析了Leksell伽玛刀Perfexion(LGK PFX)治疗多发转移瘤和良性肿瘤的效率。我们还比较了LGK PFX和LGK 4C针对良性肿瘤的治疗计划适形性。
在6周的时间间隔内,匹兹堡大学的37例患者(21例多发脑转移瘤患者和16例良性肿瘤患者)接受了LGK PFX放射外科治疗。我们使用适用于LGK PFX和LGK 4C的Leksell伽玛计划为所有患者制定了剂量计划。LGK PFX和LGK 4C的处方剂量相同。
LGK 4C和LGK PFX在总照射时间上未观察到显著差异。对于多发转移瘤患者,LGK PFX设置时间的中位数减少为每位患者53分钟(范围19 - 125分钟)。对于良性肿瘤患者,LGK PFX设置时间的中位数减少为每位患者16分钟(范围5 - 53分钟)。LGK 4C和LGK PFX在剂量适形性方面没有显著差异。
本研究表明,LGK PFX除了扩大了颅内照射范围外,还显著提高了多发脑转移瘤患者的治疗效率。对于良性肿瘤放射外科治疗,LGK PFX提高了治疗效率,且在适形性方面无显著差异。