在传统直线加速器上进行图像引导的立体定向脊柱放射外科手术。

Image-guided stereotactic spine radiosurgery on a conventional linear accelerator.

作者信息

Wang Jia-Zhu, Rice Roger, Mundt Arno, Sandhu Ajay, Murphy Kevin

机构信息

Department of Radiation Oncology, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA.

出版信息

Med Dosim. 2010 Spring;35(1):53-62. doi: 10.1016/j.meddos.2009.01.007. Epub 2009 Mar 6.

DOI:10.1016/j.meddos.2009.01.007

PMID:19931016

Abstract

Stereotactic radiosurgery for spinal metastasis consists of a high radiation dose delivered to the tumor in 1 to 5 fractions. Due to the high radiation dose in a single or fewer treatments, the precision of tumor localization and dose delivery is of great concern. Many groups have published their experiences of spinal radiosurgery with the use of CyberKnife System (Accuray Inc.). In this study, we report in detail our approach to stereotactic spine radiosurgery (SSRS) using a conventional linear accelerator (Varian Trilogy), utilizing the features of kilovolt on-board imaging (kV-OBI) and cone beam computed tomography (CBCT) for image guidance. We present our experience in various aspects of the SSRS procedure, including patient simulation and immobilization, intensity-modulated radiation treatment (IMRT) planning and beam selection, portal dosimetry for patient planning quality assurance (QA), and the use of image guidance in tumor localization prior to and during treatment delivery.

摘要

脊柱转移瘤的立体定向放射外科治疗是指在1至5次分割照射中向肿瘤给予高剂量辐射。由于单次或较少次数治疗中的高辐射剂量，肿瘤定位和剂量给予的精确性备受关注。许多研究团队已发表了他们使用射波刀系统（Accuray公司）进行脊柱放射外科治疗的经验。在本研究中，我们详细报告了我们使用传统直线加速器（瓦里安Trilogy）进行立体定向脊柱放射外科治疗（SSRS）的方法，利用千伏级机载成像（kV-OBI）和锥形束计算机断层扫描（CBCT）的特性进行图像引导。我们展示了在SSRS程序各个方面的经验，包括患者模拟与固定、调强放射治疗（IMRT）计划与射束选择、用于患者计划质量保证（QA）的射野剂量测定，以及在治疗实施前和治疗过程中使用图像引导进行肿瘤定位。