Szeifert G, Nyáry I
Országos Idegsebészeti Tudományos Intézet, Budapest.
Orv Hetil. 1998 Nov 1;139(44):2627-32.
The gamma knife is a dedicated neurosurgical equipment for brain surgery to treat predetermined intracranial normal or pathological targets through the intact skull without damaging the surrounding normal brain tissue. The operating method is called radiosurgery and it works with the biological effect of stereotactically directed, highly focused ionizing beams of 201 independent cobalt-60 sources. The treatment is a single day procedure with obvious advantages over the invasive conventional craniotomy-related surgery. It has the benefits of increased biological efficacy of the irradiation along with decreased hospital stay and side effects. The device and radiosurgery was originally developed to treat functional neurological diseases, but very soon arteriovenous malformations and tumours became the main objects for the method, and a new dimension opened in the treatment of brain pathologies with difficult access. The first gamma knife was installed in Stockholm, Sweden in 1968. Since then 85 units have been set up, and more than 70,000 patients were treated with the device worldwide. The simple management technique and high mechanical and beam accuracy made the gamma knife a reliable and effective tool for its intended purpose over 30 years now. This review summarizes the history of the device, the basic radiation physics and biology related to stereotactic radiosurgery, the description of the unit and the possibilities and limits of the treatment modality.
伽玛刀是一种专门用于脑部手术的神经外科设备，它通过完整的颅骨治疗预先确定的颅内正常或病理靶点，而不会损伤周围正常脑组织。其操作方法称为放射外科手术，它利用201个独立钴-60源的立体定向、高聚焦电离束的生物效应来工作。该治疗为单日手术，与侵入性传统开颅手术相比具有明显优势。它具有提高照射生物效能、缩短住院时间和减少副作用的优点。该设备和放射外科手术最初是为治疗功能性神经疾病而开发的，但很快动静脉畸形和肿瘤就成为了该方法的主要治疗对象，为难以治疗的脑部病变开辟了新的治疗维度。第一台伽玛刀于1968年安装在瑞典斯德哥尔摩。从那时起，已经建立了85台设备，全球有超过70000名患者接受了该设备的治疗。简单的管理技术以及高机械和射束精度使伽玛刀在30多年来一直是实现其预期目的的可靠而有效的工具。本综述总结了该设备的历史、与立体定向放射外科相关的基本放射物理学和生物学、设备描述以及该治疗方式的可能性和局限性。
