TOMO、射波刀、伽玛刀等放疗技术比较及实际使用交流贴

老马 发表于 2012-2-26 02:24

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TomoTherapy--螺旋断层放射放疗
8 r% E- V! V3 n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 ...

5 U. V4 `( Q2 R# N) x) S7 O弱弱的问老马，有适合巨型的放疗么

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）。

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

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？

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.
  L  ^, q( L- M+ a) @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.
( P" G- F" L) I  Y- _5 gSourceDepartment of Radiation Oncology, University of Virginia Health Sciences Center, Charlottesville, Virginia 22908, USA.
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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.

& r) I) h8 Y- E! j  S9 UMETHODS: 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.

5 m) u, p3 K: f8 c# ~# VRESULTS: 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).
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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.
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常弓 发表于 2012-8-21 20:18

                               
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$ P/ l1 q! S, a8 C# J) h5 H我们打算做伽马刀

; ^8 T) x! s- q: y千万不要做伽马刀，这已经是几乎被淘汰的技术，我父亲治病时候两个病友，肺转移，都是做完伽马刀以后病情恶化很快就走了，一定要做放疗，建议做射波刀和TOMO，虽然价格相对伽马刀高昂很多，但无论从疗效精确度还是病人的副反应来说，都远胜伽马刀

我本人于2011年6月，因为头部核磁观察，原有疑似单发病灶有水肿，医生建议做头部X刀治疗，做一个头部面部磨具，当时是两天做一次，我一共照射了五次，没有任何不适感觉，治疗后至今稳定，我本人考虑头部或许不是转移病灶。

前世今生 发表于 2012-11-25 17:40

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) u4 h7 c% ]2 m我本人于2011年6月，因为头部核磁观察，原有疑似单发病灶有水肿，医生建议做头部X刀治疗，做一个头部面部磨 ...

7 H8 A# m4 O$ S5 t+ ]照肿瘤病人的治疗规律，不管怎样，稳定就好，也不去管是否误诊了，这也是我们的悲哀

我刚做了伽马刀不久现状况还好

不错顶