Beach L, Young A B, Patchell R A
Lexington Radiation Therapy Center, KY 40504.
Int J Radiat Oncol Biol Phys. 1993 May 20;26(2):347-51. doi: 10.1016/0360-3016(93)90216-i.
This paper describes a system for the implantation of rigid stainless steel afterloading tubes into the brain using a stereotaxic head frame for both localization and treatment.
The stereotaxic frame is attached to the skull throughout the treatment, and the afterloading tubes are both rigid and fixed to the frame. The source positions are therefore fixed relative to the skull throughout the irradiation. Design and construction of templates, afterloading tubes and clamps are discussed in detail.
The rigidity of the resulting implant provides accurate and immobile positioning of the planned isodose distribution relative to the defined treatment volume and makes it possible to carefully and rapidly plan a source loading which will best cover the volume of interest. The source template is not in contact with the patient at any time. The afterloading tubes are held strictly parallel during treatment, allowing for rapid and versatile preplanning prior to surgical placement. Placement options are enhanced by using a set of rotating templates.
This system has been used for over 60 procedures without any mechanical or safety problems and has provided a significant improvement in both the speed and confidence of localization and treatment planning. There are significant advantages of such a system for High Dose Rate Afterloading Brachytherapy.
本文描述了一种使用立体定向头架进行定位和治疗，将刚性不锈钢后装管植入脑部的系统。
在整个治疗过程中，立体定向框架固定在颅骨上，后装管是刚性的且固定在框架上。因此，在整个照射过程中，源位置相对于颅骨是固定的。详细讨论了模板、后装管和夹具的设计与构造。
最终植入物的刚性使得计划的等剂量分布相对于确定的治疗体积能够精确且固定地定位，并使得能够仔细且快速地规划源加载，从而最佳地覆盖感兴趣的体积。源模板在任何时候都不与患者接触。在治疗过程中，后装管保持严格平行，这使得在手术放置前能够进行快速且通用的预规划。通过使用一组旋转模板，放置选择得到了增强。
该系统已用于60多次手术，没有出现任何机械或安全问题，并且在定位和治疗计划的速度及可信度方面都有显著提高。对于高剂量率后装近距离放射治疗，这样的系统具有显著优势。
