Goodman M L
South Med J. 1990 May;83(5):551-4. doi: 10.1097/00007611-199005000-00016.
"Radiosurgery" is stereotactic neurosurgery in which the usual rigid needles or probes are replaced with beams of ionizing radiation directed toward an intracranial target so as to achieve local tissue destruction. No skin incision or skull opening is required. Lars Leksell originally defined the concept and over a prolonged research and development period created the "Gamma Knife." The Gamma Knife is a self-contained unit with 201 cobalt 60 sources arranged in a hemispheric array such that the emitted beams of radiation reach a common point of intersection. Interchangeable collimating devices allow variation of the diameter of the 50% isodose distribution from 5.0 to 24.2 mm. Larger radiation dose distributions can be achieved by multiple overlapping exposures. Initial radiation dose rate is between 300 and 400 cGy/min. Obliteration of arteriovenous malformations has been shown angiographically in 80% to 86% of optimally treated patients two years later. Growth arrest or actual decrease in tumor size has occurred in 86% of acoustic neuromas treated. Other lesions treated with the Gamma Knife have included pituitary adenomas, craniopharyngiomas, pineal region tumors, and ocular melanomas, as well as functional disorders.
“放射外科”是一种立体定向神经外科手术，其中通常使用的刚性针或探头被指向颅内靶点的电离辐射束所取代，以实现局部组织破坏。无需进行皮肤切口或颅骨切开。拉尔斯·莱克塞尔最初定义了这一概念，并在漫长的研发过程中创造了“伽马刀”。伽马刀是一个独立的设备，有201个钴60源排列成半球形阵列，使发射的辐射束到达一个共同的交点。可互换的准直装置允许50%等剂量分布的直径在5.0至24.2毫米之间变化。通过多次重叠照射可实现更大的辐射剂量分布。初始辐射剂量率在300至400厘戈瑞/分钟之间。两年后，在80%至86%接受最佳治疗的患者中，血管造影显示动静脉畸形已闭塞。在接受治疗的听神经瘤中，86%出现了生长停滞或肿瘤大小实际缩小。用伽马刀治疗的其他病变包括垂体腺瘤、颅咽管瘤、松果体区肿瘤和眼部黑色素瘤，以及功能性疾病。
