Marks L B, Spencer D P
Division of Radiation Oncology, Duke University Medical Center, Durham, North Carolina.
J Neurosurg. 1991 Aug;75(2):177-80. doi: 10.3171/jns.1991.75.2.0177.
Radiosurgery (delivery of a high dose of radiation to a small volume of the brain) is usually well tolerated since the volume of brain irradiated is small. Despite growing interest in radiosurgery, the influence of the volume of brain irradiated on the tolerance of the brain to radiation is not well understood. The results of six studies reporting clinically significant radiation reactions following radiosurgery for arteriovenous malformations are reviewed. In the combined series, 23 (9%) of 255 patients developed a clinically significant radiation reaction. The volume of brain irradiated and the dose delivered in each of these 23 patients are presented. The compiled data suggest that the previously presented guidelines may underestimate the risks of radiosurgery. Additional clinical and experimental data are needed to determine "safe" doses of radiation to be used during radiosurgery.
放射外科（向脑内小体积区域输送高剂量辐射）通常耐受性良好，因为接受辐射的脑体积较小。尽管人们对放射外科的兴趣与日俱增，但脑辐射体积对脑辐射耐受性的影响尚未得到充分了解。本文回顾了六项关于动静脉畸形放射外科治疗后出现具有临床意义的辐射反应的研究结果。在综合系列研究中，255例患者中有23例（9%）出现了具有临床意义的辐射反应。文中列出了这23例患者各自的脑辐射体积和所输送的剂量。汇总的数据表明，先前提出的指导方针可能低估了放射外科的风险。需要更多的临床和实验数据来确定放射外科治疗期间使用的“安全”辐射剂量。
