摘要：A simple procedure to plan, verify and implement craniospinal irradiation（CSI） with patients supine is presented. Treatment is conducted with a single posterior spinal field abutting two lateral cranial fields. The opposed lateral fields are half-blocked and the inferior line is perpendicular. The posterior field uses some fixed field parameters so that the cephalad edge of the posterior field is coplanar with the caudal edges of the lateral fields and it is independent of the height of the couch. A steel-shot ball is used to measure the size of overlap or gap at the junction using portal images of an electron portal image device or portal films. The results of analyzing the portal images show that the errors of the junction are within ± 1 mm. The dose-volume histograms （DVHs）show that there are not unbearable hot or cold spots in the clinic target volumes （CTVs）. Supine craniospinal treatment is a reliable and convenient alternative to treatment in the prone position and avoids the technical difficulties of the latter. The use of fixed field geometry greatly facilitates treatment planning and effectively reduces the amount of time of setup, verification and treatment.

摘要：目的:介绍射波刀治疗颅内病变的技术、经验及技巧。方法:45例颅内肿瘤或病变经CT1mm层厚定位扫描,其中40例另行3mm层厚MRI扫描以与CT图像融合,MultiPlan计划系统设计治疗计划,采用6维颅骨追踪技术行射波刀治疗,中位治疗次数3(2～5),中位处方剂量24Gy(15～35Gy)。结果:45例患者均顺利完成。经3～9个月随访,CR12例,PR28例,SD4例,PD0例,1例失访,总有效率88.9%。2例RTOG急性放射损伤2级,6例RTOG/EORTC晚期放射损伤1级。结论:颅内病变射波刀治疗适应证广泛,具备无创、疗程短、精度高、剂量跌落快等特点。

摘要：射波刀设计独特,是利用灵活的机械臂操控的直线加速器,在影像定位系统引导下实现无框架立体定位放射外科治疗。同步呼吸跟踪系统在放射治疗过程中动态补偿呼吸运动,使运动器官的肿瘤也能得到放射外科治疗。作者结合射波刀的组成和特点,综述射波刀在立体定位放射外科中的临床优势。

摘要：立体定向治疗技术是把先进的影像、立体定位技术和高精度聚焦X线技术巧妙地结合为一体,特点是靶区定位和摆位的准确以及剂量在靶区内的高度集中.全过程分病变定位、计划设计和计划实施三个阶段.立体定向治疗经数年的临床研究被公认为脑转移瘤的有效治疗方法,而分次治疗更符合放射生物学特性.应用头模行立体定向分次治疗实现了每次摆位的高重复性和高精度,同时也保证了疗效.作者主要针对头模的制作和计划实施作一介绍.