TOMO、射波刀、伽玛刀等放疗技术比较及实际使用交流贴

祈福心愿 · 发表于 2012-8-26 00:21:21

老马发表于 2012-2-26 02:24
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TomoTherapy--螺旋断层放射放疗
+ A; G+ F* w/ M螺旋断层放疗系统（TOMO）集IMRT（调强放射治疗）和IGRT（图像引导放射治疗 ...

弱弱的问老马，有适合巨型的放疗么

lostm · 发表于 2012-9-17 21:34:26

乏血供HCC，gamma刀后二月复查MRI提示肿瘤进展，此期二月未采用其它治疗手段（只吃保肝药）。

鬼城军人 · 发表于 2012-10-7 15:55:09

沈阳军区总医院也有一台TOMO啦，我就是做的这个，效果还是不错的

wurong_zju · 发表于 2012-10-19 15:09:41

本帖最后由 wurong_zju 于 2012-10-22 09:52 编辑

请问各位，恶性间皮瘤可不可以作放疗？Tomo, 射波，伽玛那种合适些？

平安！ · 发表于 2012-11-8 00:38:30

脑部放疗，上午比下午敏感许多！

Cancer 2011 Jan 15;117(2):414-20. doi: 10.1002/cncr.25423. Epub 2010 Sep 9.
Gamma knife radiosurgery for brain metastasis of nonsmall cell lung cancer: is there a difference in outcome between morning and afternoon treatment?
Rahn DA 3rd, Ray DK, Schlesinger DJ, Steiner L, Sheehan JP, O'Quigley JM, Rich T.
SourceDepartment of Radiation Oncology, University of Virginia Health Sciences Center, Charlottesville, Virginia 22908, USA.

Abstract
BACKGROUND: Circadian cell-cycle progression causes fluctuating radiosensitivity in many tissues, which could affect clinical outcomes. The purpose of this study was to determine whether outcomes of single-session gamma knife radiosurgery (GKRS) for metastatic nonsmall cell lung cancer (NSCLC) differ based on treatment time.

METHODS: Fifty-eight patients received GKRS between 10:00 am and 12:30 pm and 39 patients received GKRS between 12:30 pm and 3:00 pm. The mean peripheral dose was 18.6 Gy. The mean tumor size was 7.3 cm³. Magnetic resonance imaging was used to score local control at 3 months. Cause of death (COD) was categorized as central nervous system (CNS)-related or systemic.

RESULTS: Demographic and disease characteristics of the 2 groups were similar. Local control at 3 months was achieved in 97% (35/36) of patients who underwent GKRS early in the day versus 67% (8/12) of patients who underwent GKRS later in the day (chi-square, P = .014). Early GKRS was associated with better survival (median 9.5 months) than late GKRS (median 5 months) (Kaplan-Meier log-rank test, P = .025). Factors contributing to better survival in a Cox regression model included early treatment time (P = .004) and recursive partition analysis class (P < .001). Cause of death in the early treatment group was CNS-related in 6% (3/47) of patients versus 24% (8/34) of patients in the late treatment group (chi-square test, P = .026).

CONCLUSIONS: GKRS for metastatic NSCLC had better local control, better survival, and a lower rate of CNS-related cause of death when given earlier in the day versus later in the day. These retrospective data should encourage future study in brain radiosurgery and non-CNS stereotactic body radiotherapy series.