直线加速器立体定向放射外科治疗颅内病变的研究

STUDY OF INTRACRANIAL LESION TREATED BY LINEAR ACCELERATOR STEREOTACTIC RADIOSURGERY

用 Ｗ ｉｎｓｔｏｎ Ｌｕｔｚ 法测定 Ｘ刀二次等中心系统的精度，应用人体头颅模型的特定标记物测定 Ｃ Ｔ 定位的精度，应用不同的扫描方法对颅内病变进行 Ｃ Ｔ 定位，观察效果，并用自身对照方法，随访了经 Ｘ刀治疗后 ６～２４ 月的患者。结果显示， Ｘ刀二次等中心系统误差 ０１９ｍ ｍ ，最大误差 ０５ｍ ｍ ， Ｂ Ｒ Ｗ Ｃ Ｔ 头颅定位误差０６５ｍ ｍ ，最大误差１０９ｍ ｍ 。 Ｘ刀治疗误差为０６８ｍ ｍ ，最大１２０ｍ ｍ 。８７ 例应用 Ｃ Ｔ 扫描定位，７５９％ 定位效果好。随访过程中症状改善率为５６２％ ，症状稳定率为８８８％ 。肿瘤控制率为７４８％ ，症状性脑水肿发生率为 １５１％ ，表明 Ｘ刀治疗机械精度较高，对颅内病变的治疗效果满意。

This article study the accuracy of isocenter subsystem of X knife using Winston Lutz method, and the accuracy of CT localization by special markers in skull base phantom. The effect of tumor localization was studied by using different scanning method. Following up results are analyzed with patient autocontrol method for patients treated with X knife more than 6 months. The results show that the accuracy of X knife isocenter subsystem is 0.19mm, maximal error is 0.5mm. The accuracy of BRW CT skull localization is o.68 mm, maximal error is 1.20mm. The CT localization effects are satisfied in 75.9% of 87 patients. 56.2% patients symptoms progressed and 88.8% are stable in clinical symptoms during following up period. Tumor control rate is 74.8%, and 15.1% patients appear symptomatic brain edma. It suggests that the mechanical accuracy of X knife in our hospital is very high, and the effects of X knife treatment for intracranial lesion are satisfactory.