临床肿瘤医师如何善用放射外科的新利器

目的:阐述放射外科的新进展,并建议临床肿瘤医师应采取的应用态度。方法:回顾放射外科的发展史,包括伽马刀、X刀的应用,以及射波刀的特点、优点和目前的临床应用经验。结果:资料显示射波刀自2001年获美国FDA核准作为全身放射外科治疗仪器后,至2006年底在美、欧、亚洲国家已有90家医院,约两万五千个临床病例使用过射波刀治疗颅内、脊椎、躯干良性和恶性肿瘤以及颅内和脊髓动静脉畸形、三叉神经痛。由于临床精准度达1mm以下,治疗中能靠影像导引多次修正患者体位移动,能1～5次大剂量照射而获得良好的治疗成效。射波刀还能治疗随呼吸而移动的肿瘤如肝、肺、胰、前列腺、肾等不必照射大体积的正常组织,是放射外科非常独特和优良的利器。结论:射波刀是放射外科非常卓越的新利器。

How Clinical Oncologists Best Utilize the New Equipment of Radiosurgery

Objective: To described the recent advancement of radiosurgery and suggest the attitude of the clinical oncologists toward the clinical application. Methods: The history and development of radiosurgery, including the application of Gamma-Knife and X-Knives, the characteristics, advantages and the summary of clinical application of CyberKnife was reviewed. Results: Data showed that since official approval from FDA for the whole-body radiosurgical equipment in 2001, up to the end of 2006, CyberKnife has been used for treatment of over 25,000 patients with intracranial, spinal and extracranial benign and malignant tumors, arteriovenous malformation and trigeminal neuralgia in 90 hospitals in U.S., Europe and Asia. Due to a clinical accuracy of no more than 1 submillimeter and possibly frequent image-guided radiotherapy (IGRT) and correction for body movement during irradiation, CyberKnife can treat patients with a large radiation dose by 1 to 5 fractions, with good results. CyberKnife can also treat tumors moving with respiration, such as those in lung, liver, pancreas, prostate and kidney, without irradiating normal tissues of a large area. CyberKnife was a unique and excellent equipment of radiosurgery. Conclusion: CyberKnife is a new and superordinary device of radiosurgery. It is recommended that the clinical oncologists should participate in the development of the clinical technology to become the future specialists of CyberKnife radiosurgery.