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目的:探讨应用立体定向三维(X-刀)治疗颅内疾病的近期疗效、远期疗效、副反应及放射损伤。方法:分析研究颅内疾病的CT、MRI以及周边结构的关系,根据疾病部位、大小的不同,拟定不等的治疗剂量,应用立体定向三维放射治疗。采用瓦里安2100C型加速器6MVx线,每个靶区4-9个非共面弧,等中心剂量范围为15-25Gy,单次照射,平均为19Gy,同时应用脱水、抗感染药物治疗。结果:本组1750例经治疗后有1697例获得随访,随访率97%。根据CT或MRI复查肿瘤退缩情况确定为CR者594例占35%,PR者1069例占63%,NC34例占2%,PD为0,总有效率为(CR+PR)达98%。结论:应用立体定向三维放射治疗颅内疾病是一种当今十分理想、疗效确切、安全、副作用小的治疗方法,但只有严格把握适应症,使用合理的治疗剂量,保护好靶区以外的正常结构,才能取得良好的效果,提高患者的生存质量。
Objective: To explore the short-term curative effect, long-term curative effect, side effects and radiation injury in the treatment of intracranial diseases with stereotactic three-dimensional (X-knife) treatment. Methods: The relationship between CT, MRI and peripheral structures of intracranial diseases was analyzed and studied. According to the different parts and sizes of the disease, unequal treatment doses were formulated and stereotactic three-dimensional radiotherapy was applied. Varian 2100C accelerator with 6MVx lines, 4-9 non-coplanar arcs per target, isocenters dose range of 15-25Gy, a single irradiation, an average of 19Gy, at the same time the application of dehydration, anti-infective drug treatment. Results: The group of 1750 cases after treatment, 1697 cases were followed up, the follow-up rate was 97%. According to the CT or MRI examination of tumor regression, 594 cases were defined as CR, accounting for 35%, PR 1069 63%, NC 34 2%, PD 0, and the total effective rate was (CR + PR) 98%. Conclusion: Stereotactic three-dimensional radiation treatment of intracranial diseases is a very ideal, effective, safe and less side effects treatment methods, but only strictly indications, the use of reasonable doses to protect the normal structure outside the target area , In order to achieve good results and improve the quality of life of patients.