SBRT临床应用结果的思考

体部立体定向放射治疗（Stereotactic Body Radiation Therapy，SBRT）是应用立体定位技术和特殊射线装置，将多源、多线束或多野三维空间聚焦的高能射线聚焦于体内某一靶区，使病灶组织受到高剂量照射，周围正常组织受量减少，从而获得临床疗效高，副作用小的一类放疗技术的总称，采用γ射线所完成的SBRT简称为γ刀，采用X射线所完成的SBRT简称为X刀。SBRT的优势是采用高分次荆量、短疗程分割模式，具有明显的放射生物学优势。无论是国外还是国内，SBRT治疗肿瘤的临床结果均令人鼓舞，治疗早期非小细胞肺癌的3年生存率和局控率均优于常规放疗，与手术效果无差异，而且副作用小，治疗肝癌和胰腺癌的局控率和生存率也获得了大幅度提高。我国的γ刀技术具有独特的剂量聚焦优势和完全自主知识产权，符合我国“十一五”科技自主创新的要求，而且疗效显著、性价比高、易于推广应用符合我国国情。但由于种种原因，SBRT技术在中国尚未引起足够重视，中国γ刀技术需要从设备完善、加大政府支持力度和规范临床应用三个方面进行改进，SBRT的健康发展对推动我国放射肿瘤专业发展具有重要意义。

The Thinking of SBRT Clinical Application Outcomes

Stereotactic Body Radiation Therapy （SBRT） is a general term of radiation therapy, which apples stereotactic technique and special ray generating equipment that focuses high energy rays of multi- source, multi- beam, or multi - field on a target, obtaining high curative but low side effect, because of high target dose and low normal tissue dose. SBRT that uses γ my is called γ knife, and uses X ray is called X knife. High fractional dose and short period of treatment is adopted by SBRT, which shows obvious radiobiological advantages.The clinical results of SBRT treating tumour were encouraged at home and abroad. The local control rate and 3 - year survival rate of SBRT treating NSCLC in early stage were superior to conventional radiotherapy, and had no difference with surgery, and furthermore, with lower side effect. The local control rate and survival rate of SBRT treating liver cancer and pancreas cancer were both improved dramatically. The γ knife techniques developed by China have unique dose focusing characteristics and possess entirely independent intellectual property rights. It is in accordance with the demands of science and technology innovation in the Eleventh Five- Year plan.It also accord with China＇ s national conditions because of remarkable curative effect, high cost performance, and easily popularizing and applying. But for various reasons, adequate attention hasn＇ t been given to SBRT in China, and the γ knife technique should be improved in the following three aspects： equipment improving, increasing government support, and standardization of clinical application. The healthy development of SBRT is of great significance in pushing forward the overall development of Radiation Oncology in China.