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微真空-精确接触式眼球模型在眼球肿瘤X射线放射外科治疗中的应用

The application of micro-vacuo-certo-contacting ophthalmophanto in X-ray radiosurgery for tumors in an eyeball.

作者信息

Li Shuying, Wang Yunyan, Hu Likuan, Liang Yingchun, Cai Jing

机构信息

Radiotherapy Department, Qilu Hospital, Shandong University, Jinan, 250012, Shandong Province, People's Republic of China.

出版信息

Tumour Biol. 2014 Nov;35(11):11455-60. doi: 10.1007/s13277-014-2415-x. Epub 2014 Aug 15.

Abstract

The large errors of routine localization for eyeball tumors restricted X-ray radiosurgery application, just for the eyeball to turn around. To localize the accuracy site, the micro-vacuo-certo-contacting ophthalmophanto (MVCCOP) method was used. Also, the outcome of patients with tumors in the eyeball was evaluated. In this study, computed tomography (CT) localization accuracy was measured by repeating CT scan using MVCCOP to fix the eyeball in radiosurgery. This study evaluated the outcome of the tumors and the survival of the patients by follow-up. The results indicated that the accuracy of CT localization of Brown-Roberts-Wells (BRW) head ring was 0.65 mm and maximum error was 1.09 mm. The accuracy of target localization of tumors in the eyeball using MVCCOP was 0.87 mm averagely, and the maximum error was 1.19 mm. The errors of fixation of the eyeball were 0.84 mm averagely and 1.17 mm maximally. The total accuracy was 1.34 mm, and 95% confidence accuracy was 2.09 mm. The clinical application of this method in 14 tumor patients showed satisfactory results, and all of the tumors showed the clear rims. The site of ten retinoblastomas was decreased significantly. The local control interval of tumors were 6 ∼ 24 months, median of 10.5 months. The survival of ten patients was 7 ∼ 30 months, median of 16.5 months. Also, the tumors were kept stable or shrank in the other four patients with angioma and melanoma. In conclusion, the MVCCOP is suitable and dependable for X-ray radiosurgery for eyeball tumors. The tumor control and survival of patients are satisfactory, and this method can effectively postpone or avoid extirpation of eyeball.

摘要

眼球肿瘤常规定位的较大误差限制了X射线放射外科的应用,原因仅在于眼球会转动。为了定位精确部位,采用了微真空确定性接触眼模(MVCCOP)方法。此外,还评估了眼球肿瘤患者的治疗结果。在本研究中,通过使用MVCCOP重复CT扫描以在放射外科中固定眼球来测量计算机断层扫描(CT)定位精度。本研究通过随访评估了肿瘤的治疗结果和患者的生存率。结果表明,Brown-Roberts-Wells(BRW)头环的CT定位精度为0.65mm,最大误差为1.09mm。使用MVCCOP对眼球肿瘤进行靶区定位的平均精度为0.87mm,最大误差为1.19mm。眼球固定的误差平均为0.84mm,最大为1.17mm。总精度为1.34mm,95%置信精度为2.09mm。该方法在14例肿瘤患者中的临床应用显示出满意的结果,所有肿瘤均显示出清晰的边缘。10例视网膜母细胞瘤的部位明显缩小。肿瘤的局部控制期为6至24个月,中位数为10.5个月。10例患者的生存期为7至30个月,中位数为16.5个月。此外,其他4例患有血管瘤和黑色素瘤的患者的肿瘤保持稳定或缩小。总之,MVCCOP适用于眼球肿瘤的X射线放射外科且可靠。患者的肿瘤控制和生存率令人满意,该方法可有效推迟或避免眼球摘除。

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