European Radiosurgery Center Munich, Munich, Germany.
European Radiosurgery Center Munich, Munich, Germany; Department of Stereotaxy and Functional Neurosurgery, University Hospital Cologne, Cologne, Germany.
World Neurosurg. 2022 Aug;164:e420-e426. doi: 10.1016/j.wneu.2022.04.120. Epub 2022 May 11.
Self-shielding gyroscopic radiosurgery (GRS) represents a technical innovation in the field of stereotactic radiosurgery. GRS does not require a radiation vault and is optimized for radiosurgical treatments. Reports on its usage are limited. We describe the first clinical experience of GRS at our institution to assess the application of GRS in the treatment of cranial tumors. Moreover, we perform a dosimetric comparison to robotic radiosurgery (RRS) with vestibular schwannoma (VS) GRS patients.
Patients who were treated with GRS between July and November 2021 were included. Patient, tumor, and dosimetric characteristics were retrospectively summarized and analyzed.
Forty-one patients with 48 intracranial tumors were included. Tumor entities mostly comprised VS, brain metastases, and meningiomas. The median prescription dose and isodose line were 13.5 Gy and 50.0% for benign neoplasia versus 20 Gy and 60.0% for malignant tumors, respectively. The mean planning target volume was 1.5 cubic centimeters. All patients received a single-fraction treatment without encountering any technical setup difficulties. Treatment plan comparisons with RRS revealed comparable plan characteristics, dose gradients, and organs at risk doses. Significant differences were detected concerning the new conformity index and number of monitor units per treatment (both P < 0.01).
This case series provides more evidence on the usage of self-shielding GRS in the management of cranial tumors. Dosimetric comparisons for VS cases revealed mostly equivalent dosimetric characteristics to RRS. Further clinical and physical analyses for GRS are underway.
自屏蔽旋转式伽玛刀（GRS）代表了立体定向放射外科领域的一项技术创新。GRS 不需要辐射防护室，并且针对放射外科治疗进行了优化。关于其使用的报告有限。我们描述了我们机构首次使用 GRS 的临床经验，以评估 GRS 在治疗颅肿瘤中的应用。此外，我们对前庭神经鞘瘤（VS）GRS 患者的机器人放射外科（RRS）进行了剂量学比较。
纳入 2021 年 7 月至 11 月期间接受 GRS 治疗的患者。回顾性总结和分析患者、肿瘤和剂量学特征。
共纳入 41 例 48 个颅内肿瘤患者。肿瘤实体主要包括 VS、脑转移瘤和脑膜瘤。良性肿瘤的中位处方剂量和等剂量线分别为 13.5Gy 和 50.0%，恶性肿瘤分别为 20Gy 和 60.0%。平均计划靶体积为 1.5 立方厘米。所有患者均接受单次分割治疗，未遇到任何技术设置困难。与 RRS 的治疗计划比较显示，具有相似的计划特征、剂量梯度和危及器官剂量。新的适形指数和每个治疗的监测单位数量存在显著差异（均 P<0.01）。
本病例系列为自屏蔽 GRS 在颅肿瘤管理中的应用提供了更多证据。VS 病例的剂量学比较显示，与 RRS 相比，大多数剂量学特征相似。正在进行 GRS 的进一步临床和物理分析。
