图像引导体部伽玛刀治疗的临床应用效果

Clinical application effect of image-guided body gamma knife treatment

目的 探讨图像引导体部伽玛刀治疗的临床应用效果.方法 收集海军总医院2013年10月～2014年10月应用图像引导伽玛刀治疗的60例不同种类和部位肿瘤患者,观察近期（12周）的治疗效果.选出其中2例典型患者分别运用重复定位尺和图像引导摆位,并对两种摆位方法产生的误差进行比较.结果 治疗12周,显效42例,有效9例,无变化3例,进展3例,总有效率为85％.图像引导伽玛刀治疗患者摆位误差明显优于重复定位尺引导伽玛刀的摆位误差,差异有统计学意义（P＜0.05）.结论 图像引导体部伽玛刀在原有伽玛刀的精确定位框架基础上提高了治疗精度,降低了摆位误差及靶区运动所引起的误差,是体部伽玛刀治疗技术与图像引导系统一次完美结合,是体部伽玛刀治疗精度的一次质的飞跃,属于全新的伽玛刀治疗模式,值得广泛推广应用.

Objective To expound the clinical application effect of the image-guided body gamma knife.Methods From October 2013 to October 2014,in Navy General Hospital,60 patients with different types and locations tumor were selected,the treatment effect after treated 12 weeks of them was observed.2 typical cases chosen from them were given repeated positioning ruler and laser positioning image guided placement respectively,and the errors caused by two kinds of placement method were compared.Results After the treatment 12 weeks,42 cases were excellent,9 cases were effective,3 cases were no-change,3 cases were advance,total effective rate was 85％.Errors of laser positioning image guided placement were better than that of positioning ruler guided placement,the differences were statistically significant （P ＜ 0.05）.Conclusion Image-guided body gamma knife treatment can improved the precision of the treatment based on the accurate positioning with original gamma knife framework,and reduce the positioning error and the error caused by target motion.It is perfect combination with whole-body gamma knife treatment techniques and Image guided system,a qualitative leap on the accuracy of body gamma knife treatment,a new mode of gamma knife treatment,and it is worth to popularize and applicated widely.