携帯型組織内X線照射装置による脳腫瘍に対する術中照射法(Minimally Invasive Treatments,ワークショップ,<特集>東京女子医科大学学会第65回総会)

概要

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The photon radiosurgery system (PRS) is a newly developed compact radiosurgery system that irradiates soft X ray from the tip of its small probe (length=10 cm, diameter=3 mm, weight of the machine=1.9 kg). The PRS can be used either with a stereotactic frame or during a craniotomy as interstitial radiotherapy. The PRS is able to irradiate 15 Gy at the portion of 1.5 cm from the center for about 20 minutes and avoid severe damage to surrounding normal brain because of steep dose distribution curve. Background exposure is minimal and no special shielding of the patient or health care personnel is required. This time we estimated the effect of the PRS for brain tumors. We underwent the PRS to 75 patients from June 1995 to Oct. 1999. Seventy one patients underwent intraoperative irradiation after removal and four patients had interstitial irradiation after stereotactic biopsy. All 19 cases of primary anaplastic astrocytomas survived and demonstrated good Karnofski performance scale. Median survival times of 18 primary cases of glioblastoma is 23 months. Two cases of malignant lymphoma showed complete remission in CT scan 24 hours after intraoperative radiosurgery using PRS and two cases of germ cell tumor demonstrated dramatic decrease of tumor size in a short period. There was no definite newly neurological deficit. The intraoperative radiosurgery using PRS is useful adjuvant therapy for brain tumors.
2000-04-25