Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada.
J Clin Neurosci. 2011 Feb;18(2):276-9. doi: 10.1016/j.jocn.2010.04.033. Epub 2010 Dec 13.
Stereotactic body radiotherapy (SBRT) is an emerging technique for spinal tumours that is a natural succession to brain radiosurgery. The spine is an ideal site for SBRT due to its relative immobility and the potential clinical benefits of high dose delivery, particularly to optimise local control and avoid disease progression that can result in spinal cord compression. However, the proximity of the tumour to the spinal cord, with the potential for radiation myelopathy if the dose is delivered inaccurately or if the spinal cord dose limit is set too high, demands technical accuracy with radiation myelopathy a feared complication. Spine SBRT has been delivered with either a robotic-based linac system such as the Cyberknife, or with linac-based systems equipped with a multileaf collimator and image guidance system. Regardless of the technology, spine SBRT demands sophisticated treatment planning and delivery. This case-based technical review outlines the SBRT apparatus, planning and treatment delivery in use at the University of Toronto, Toronto, Canada.
立体定向体部放射治疗（SBRT）是一种新兴的脊柱肿瘤治疗技术，是脑部放射外科的自然发展。由于脊柱相对固定，以及高剂量递送的潜在临床益处，特别是可以优化局部控制并避免疾病进展导致脊髓压迫，因此脊柱是 SBRT 的理想部位。然而，肿瘤靠近脊髓，如果剂量递送不准确或脊髓剂量限制设置过高，可能会导致放射性脊髓病，这是一种令人担忧的并发症。脊柱 SBRT 可以使用基于机器人的直线加速器系统（如 Cyberknife）或配备多叶准直器和图像引导系统的基于直线加速器的系统来进行。无论使用哪种技术，脊柱 SBRT 都需要复杂的治疗计划和递送。本基于病例的技术综述概述了加拿大安大略省多伦多大学使用的 SBRT 设备、计划和治疗递送。
