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不宜手术的听神经鞘瘤可作立体定向放射外科(SRS),但过去的资料多为γ-刀治疗者。本文报道1988～1993年用以直线加速器为基础的X-刀作SRS的32例听神经鞘瘤。年龄34～88岁,平均62岁;起初症状是30例听力丧失,2例痴呆。SRS指征是17例年龄>65岁,13例术后复发,2例体弱。在接触点局麻(50％Mar-came与50％伴肾上腺素的利多卡因)后,头颅戴BRW圈于轴平面作CT和/或MRI,并在SUN4/280 80-Megaflop阵列处理机上作治疗计划,然后用6MeV直线加速器,经多个非同等平面弧放射15～20分,患者多在当天常规放疗完成后的中午或午后4时进行。机械系统的准确性在0.2±0.1mm内,准直器大小从12～35mm,平均23mm,表明较γ-刀所治的肿瘤为大,至肿瘤边缘剂量10～22.5Gy(平均15.5Gy),靶区等量曲线68％～90％(平均
Unresectable auditory nerve sheath tumors can be used for stereotactic radiosurgery (SRS), but the past data are mostly γ-knife treatment. This article reports from 1988 to 1993 with linear accelerator based X-knife SRS for 32 cases of acoustic schwannoma. The age of 34 to 88 years, mean 62 years; initial symptoms were 30 cases of hearing loss, 2 cases of dementia. SRS indications were 17 patients> 65 years of age, 13 patients relapsed, 2 patients were weak. After touching the local anesthetic (50% Mar-came and 50% epinephrine with lidocaine), the cranium was placed on the axial plane for CT and / or MRI with a BRW ring on the head and mounted on a SUN4 / 280 80-Megaflop array processor Treatment plan, and then use the 6MeV linear accelerator, by a number of non-equal plane arc radiation 15 to 20 minutes, patients were more than the usual day after the completion of routine radiotherapy at noon or 4 pm. The accuracy of the mechanical system was within 0.2 ± 0.1 mm and the collimator size was from 12 to 35 mm with an average of 23 mm, indicating that the tumors treated with γ-knife were larger than the tumor margins with a dose of 10-22.5 Gy (average 15.5 Gy) Target area isometric curve 68% to 90% (average