転移性脳腫瘍に対するガンマナイフ治療 : 10病巣以上治療時の全脳被曝線量に関する研究

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Gamma knife (GK) radiosurgery has recently been recognized as the most powerful treatment modality in managing patients with brain metastasis, be they radioresistant or not, solitary or multiple. Very recently, this treatment has been employed in patients with numerous brain metastases, even those with 10 or more lesions. However, cumulative irradiation doses to the whole brain, with such treatment, remain unknown. Since the Gamma Plan ver. 5.10 (ver. 5.30 is presently available, Leksell Gamma Plan^<(R)>) became available in November, 1998, 105 GK procedures have been performed at our two facilities, Tokyo Women's Medical University and Katsuta Hospital Mito Gamma House. The median lesion number was 17, ranging 10～43, and the median cumulative volume of all tumors was 8.72 cm^3, ranging 0.41～81.41 cm^3. The selected doses at the lesion periphery ranged 12～25 Gy, the median being 20 Gy. Based on these treatment protocols, the cumulative irradiation dose was computed. The median cumulative irradiation dose to the whole brain was 4.83, ranging 2.16～8.51 Gy; the median integrated dose to the whole brain was 6.2 J, ranging 2.16～11.9 J. The median brain volumes receiving ≧2, ≧5, ≧10, ≧15 and ≧20 Gy were 1105 (range; 410～1501), 309 (46～1247), 64 (13～282), 24 (2～77), and 8 (0～40) cm^3, respectively. The cumulative whole brain irradiation doses for patients with numerous radiosurgical targets were considered not to exceed the threshold level of normal brain necrosis.
東京女子医科大学の論文
2002-06-25

転移性脳腫瘍に対するガンマナイフ治療 : 10病巣以上治療時の全脳被曝線量に関する研究

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