Simonová G, Novotný J, Novotný J, Vladyka V, Liscák R
Oddĕlení stereotaktické a radiacní neurochirurgie Nemocnice Na Homolce, Praha.
Cas Lek Cesk. 1995 Sep 6;134(17):547-54.
Stereotactic radiotherapy is treatment of a small or medium-sized intracranial focus, using a fractionated regime and the stereotactic method. It is carried out usually on linear accelerators. The objective of the present investigation was to test the possibility of stereotactic radiotherapy using Leksell's gamma knife and Leksell's stereotactic frame.
During the period between April 1993 and November 1994 38 patients (16 women and 22 men aged 15-72 years) were indicated for stereotactic radiotherapy. The patients had the following diagnoses: adenoma of the epipharynx (1), low-grade gliomas (10), ependymoma (1), germinoma (1), meningioma (2), solitary metastases into the CNS (19), pinealomas (3) and chordoma (1). The volume of the tumour varied from 740 mm3 to 37,000 mm3. Stereotactic fractionated radiotherapy was carried out using a Leksell Gamma Knife, Electa Instrument AB, Sweden. For assessment of the total fractionated dose a linear quadratic model was used. Thus assessed value was further modified in relation to the volume and radiobiology of the tumour, critical structures surrounding the treated lesion and other factors. The total fractionated dose to the maximum varied from 20 Gy to 60 Gy and the total fractionated dose on the periphery of the tumour from 12 Gy to 30 Gy. With regard to the short time interval which has elapsed since treatment it is not yet possible to evaluate completely the achieved results; it will be possible to do so after a time interval of 1-5 years following the operation. The patients tolerated the 2-5 day fixation with a stereotactic Leksell frame very well and none of the patients developed complications.
Fractionated stereotactic radiotherapy with Leksell's gamma knife, using Leksell's stereotactic frame, is a very accurate therapeutic method with a minimal radiation load of surrounding brain tissue. It requires a short hospitalization period and is associated with no or only minimal complications and improves the quality of patient's lives.
立体定向放射治疗是使用分次照射方案和立体定向方法治疗中小型颅内病灶。通常在直线加速器上进行。本研究的目的是测试使用Leksell伽马刀和Leksell立体定向框架进行立体定向放射治疗的可能性。
在1993年4月至1994年11月期间，38例患者（16名女性和22名男性，年龄15 - 72岁）被确定适合进行立体定向放射治疗。患者的诊断如下：咽腺瘤（1例）、低级别胶质瘤（10例）、室管膜瘤（1例）、生殖细胞瘤（1例）、脑膜瘤（2例）、中枢神经系统单发转移瘤（19例）、松果体瘤（3例）和弦瘤（1例）。肿瘤体积从740立方毫米到37,000立方毫米不等。使用瑞典Electa Instrument AB公司生产的Leksell伽马刀进行立体定向分次放射治疗。对于总分次剂量的评估，使用线性二次模型。该评估值会根据肿瘤的体积、放射生物学特性、治疗病灶周围的关键结构以及其他因素进一步调整。肿瘤最大处的总分次剂量从20 Gy到60 Gy不等，肿瘤周边的总分次剂量从12 Gy到30 Gy不等。由于治疗后时间间隔较短，目前还无法完全评估所取得的结果；在手术后1至5年的时间间隔后才有可能进行评估。患者对使用Leksell立体定向框架进行的2至5天固定耐受良好，没有患者出现并发症。
使用Leksell立体定向框架，通过Leksell伽马刀进行分次立体定向放射治疗是一种非常精确的治疗方法，对周围脑组织的辐射负荷最小。它需要较短的住院时间，并发症少或仅有轻微并发症，并且提高了患者的生活质量。
