Comprehensive Epilepsy Center of Long Island, 200 Belle Terre Road, Port Jefferson, NY 11778, USA.
Neurosurg Rev. 2010 Apr;34(2):133-42. doi: 10.1007/s10143-010-0292-3. Epub 2010 Nov 19.
Since its advent during the mid-twentieth century, radiosurgery has undergone a steady evolution. Gamma Knife and linear accelerator based systems using rigid frames preceded the development of frameless devices. The present report describes the development of microbeam radiosurgery, a technique which uses submillimetric beams of radiation to treat disease. Typically, the technique is employed using parallel arrays of beams delivered via a high-fluence synchrotron source. Beam widths between 20 and 950 μm have been used with the majority of studies utilizing beam widths less than 100 μm. In addition to its high precision, the technique allows users to take advantage of two unique properties of microbeams. The first is a remarkable tolerance of healthy tissue to microbeams delivered at doses up to several hundred grays, while at the same time, tumors are highly susceptible to the lethal effects of microbeams. Together, these findings allow for a "preferential tumoricidal effect" beyond the typical dose-volume relationship. Although only used in animal experiments so far, we explore the hypothetical clinical role of microbeam radiosurgery which may be feasible in the near future. In addition to the treatment of traditional radiosurgery targets such as malignancies and vascular malformations, microbeams may allow the non-invasive treatment of functional disease such as movement disorders, epilepsy, and mental illness.
自 20 世纪中叶问世以来，放射外科经历了稳步的发展。伽玛刀和基于刚性框架的线性加速器系统先于无框架设备的发展。本报告介绍了微束放射外科的发展，这是一种使用亚毫米辐射束治疗疾病的技术。通常，该技术使用通过高通量同步加速器源输送的平行束阵列来实现。已使用 20 至 950μm 的光束宽度，而大多数研究都利用小于 100μm 的光束宽度。除了高精度外，该技术还允许用户利用微束的两个独特特性。第一个是健康组织对高达数百格雷的微束的显著耐受性，而同时，肿瘤对微束的致死作用高度敏感。这些发现共同导致了超过典型剂量-体积关系的“优先肿瘤杀伤效应”。尽管目前仅在动物实验中使用，但我们探索了微束放射外科的假设临床作用，这在不久的将来可能是可行的。除了治疗传统的放射外科靶标，如恶性肿瘤和血管畸形，微束还可能允许对运动障碍、癫痫和精神疾病等功能性疾病进行非侵入性治疗。
