中国医学装备
中國醫學裝備
중국의학장비
CHINA MEDICAL EQUIPMENT
2015年
9期
1-4,5
,共5页
王金媛%鞠忠建%王小深%杨军%陈高翔
王金媛%鞠忠建%王小深%楊軍%陳高翔
왕금원%국충건%왕소심%양군%진고상
椎体转移瘤%立体定向放射治疗%Cyberknife系统%剂量梯度%脊髓保护
椎體轉移瘤%立體定嚮放射治療%Cyberknife繫統%劑量梯度%脊髓保護
추체전이류%입체정향방사치료%Cyberknife계통%제량제도%척수보호
Spinal metastases%Stereotactic body radiation therapy%Cyberknife%Dose falling gradient%Spinal cord protection
目的：分析评价利用Cyberknife系统实施立体定向放射治疗(SBRT)技术治疗椎体转移瘤时，脊髓方向的剂量跌落趋势。方法：利用Cyberknife治疗8例胸椎转移瘤患者，根据放射治疗剂量的不同将其分为两组，其中4例患者给予靶区剂量40 Gy/5次(40 Gy组)；4例患者给予靶区剂量33 Gy/3次(33 Gy组)。采用Cyberknife系统自带的MultiPlan4.0.2治疗计划系统设计优化治疗计划，针对靶区处方剂量跌落梯度、相对剂量跌落梯度以及单位距离剂量跌落梯度3方面。统计分析Cyberknife系统治疗计划中在脊髓方向的剂量跌落趋势。结果：40 Gy组单位绝对剂量跌落速度为(0.208±0.085)mm/100 cGy，相对剂量跌落为(0.87±0.60)mm/5%Dmax，单位距离跌落速度为(353.63±160.48) cGy/mm。33 Gy组单位绝对剂量跌落速度为(0.311±0.089)mm/100 cGy，相对剂量跌落为(0.69±0.16)mm/5%Dmax，单位距离跌落速度为(266.27±94.41)cGy/mm。40 Gy组优于33 Gy组。结论：Cyberknife系统治疗椎体转移瘤时脊髓方向剂量跌落极快，对脊髓保护好；将Cyberknife精确的追踪系统应用于椎体转移瘤的立体定向放疗，对脊髓的保护安全有效。
目的：分析評價利用Cyberknife繫統實施立體定嚮放射治療(SBRT)技術治療椎體轉移瘤時，脊髓方嚮的劑量跌落趨勢。方法：利用Cyberknife治療8例胸椎轉移瘤患者，根據放射治療劑量的不同將其分為兩組，其中4例患者給予靶區劑量40 Gy/5次(40 Gy組)；4例患者給予靶區劑量33 Gy/3次(33 Gy組)。採用Cyberknife繫統自帶的MultiPlan4.0.2治療計劃繫統設計優化治療計劃，針對靶區處方劑量跌落梯度、相對劑量跌落梯度以及單位距離劑量跌落梯度3方麵。統計分析Cyberknife繫統治療計劃中在脊髓方嚮的劑量跌落趨勢。結果：40 Gy組單位絕對劑量跌落速度為(0.208±0.085)mm/100 cGy，相對劑量跌落為(0.87±0.60)mm/5%Dmax，單位距離跌落速度為(353.63±160.48) cGy/mm。33 Gy組單位絕對劑量跌落速度為(0.311±0.089)mm/100 cGy，相對劑量跌落為(0.69±0.16)mm/5%Dmax，單位距離跌落速度為(266.27±94.41)cGy/mm。40 Gy組優于33 Gy組。結論：Cyberknife繫統治療椎體轉移瘤時脊髓方嚮劑量跌落極快，對脊髓保護好；將Cyberknife精確的追蹤繫統應用于椎體轉移瘤的立體定嚮放療，對脊髓的保護安全有效。
목적：분석평개이용Cyberknife계통실시입체정향방사치료(SBRT)기술치료추체전이류시，척수방향적제량질락추세。방법：이용Cyberknife치료8례흉추전이류환자，근거방사치료제량적불동장기분위량조，기중4례환자급여파구제량40 Gy/5차(40 Gy조)；4례환자급여파구제량33 Gy/3차(33 Gy조)。채용Cyberknife계통자대적MultiPlan4.0.2치료계화계통설계우화치료계화，침대파구처방제량질락제도、상대제량질락제도이급단위거리제량질락제도3방면。통계분석Cyberknife계통치료계화중재척수방향적제량질락추세。결과：40 Gy조단위절대제량질락속도위(0.208±0.085)mm/100 cGy，상대제량질락위(0.87±0.60)mm/5%Dmax，단위거리질락속도위(353.63±160.48) cGy/mm。33 Gy조단위절대제량질락속도위(0.311±0.089)mm/100 cGy，상대제량질락위(0.69±0.16)mm/5%Dmax，단위거리질락속도위(266.27±94.41)cGy/mm。40 Gy조우우33 Gy조。결론：Cyberknife계통치료추체전이류시척수방향제량질락겁쾌，대척수보호호；장Cyberknife정학적추종계통응용우추체전이류적입체정향방료，대척수적보호안전유효。
Objective:To evaluate the dose falling gradient in the direction of the spinal cord while implementing SBRT (Stereotactic Body Radiation Therapy) technology by Cyberknife in the treatment of spinal metastases.Methods: Eight patients with spinal metastases treated with SBRT by Cyberknife were selected. Two different RT schedules were administered, 40Gy per 5 fractions(n=4), The other was 33Gy per 3 fractions(n=4). We ues the MultiPlan4.0.2 treatment planning system owning by Cyberknife system design and optimize the treatment plan. We have analysis of the dose falling gradient, speed and the falling capacity of Cyberknife treatment plan in three aspects, such as the target prescription dose falling gradient, relative dose falling gradient, and the dose falling gradient of unit distance in the direction of spinal cord.Results: For the group of 40Gy, absolute dose falling speed can be(0.208±0.085)mm/100cGy,relative dose falling is (0.87±0.60)mm/5%Dmax, the falling of unit distance can reach (353.63±160.48)cGy/mm. Similarly, for the other group of 33Gy, absolute dose falling speed is (0.311±0.089)mm/100cGy, relative dose falling is(0.69±0.16)mm/5%Dmax, the falling gradient of unit distance can be 266.27±94.41cGy/mm. The group of 40Gy seems to be better than that of 33Gy group.Conclusion: The dose in the direction of spinal cord fall fast in the treatment of spinal metastases by Cyberknife, providing a perfect protect to the spinal cord. With the addition of its unique and precise target tracking system, the using of Cyberknife in spinal metastases of SBRT for the protection of the spinal cord is safe and effective.
