LGK剂量规划系统输入数据的测试与验证

LGK (Leksell Gamma Knife)是立体定向放射神经外科设备,由钴-60同位素源、源体、屏蔽体、准直体、终准直器、立体定位系统、治疗床、电气控制系统及治疗规划系统组成,可以安全、准确、高效地实施脑部放射外科手术.LGK伽玛刀有201个钴源和准直器通道,201束射线交叉汇聚形成辐射靶点,靶点剂量场是由各单束射线在焦点处的剂量场组合而成,可以获得多源的靶点剂量场分布和等剂量曲线,从而实现对病灶的剂量规划.LGK的单源测试是为LGK新的TPS系统提供必要的剂量学参数,它包括射束的深度剂量分布TMR、离轴比OAR、准直器的相对输出因子、单源焦点剂量率等.我们采用电离室、辐射胶片、半导体测量仪等方法测量并获得了这些参数,同时测量了多源条件下的焦点剂量率和辐射剂量分布.将获得的单源的剂量学参数输入LGK新的TPS系统,对典型的病例进行了剂量和剂量场规划,并将规划结果与实测的结果进行了比较.本文重点讨论LGK的单源测试方法、测试结果以及以此为基础的TPS的剂量规划系统的验证.

516例老年病人伽玛刀治疗的触摸护理

伽玛刀治疗颅内疾病以其不开颅、创伤小、痛苦少、无感染等优点广泛地应用于临床.特别是患有高血压、冠心病、糖尿病、脑功能障碍等老年病人,更是伽玛刀治疗的首选者.我院自1996年12月-2004年6月采用OUR-XGD型旋转式伽玛刀治疗颅内各类疾病1 933例.其中60岁以上的病人516例,占26.69%.在治疗过程中,立足以人为本,以老年人的心理、生理反应为基点,实施了全过程的触摸护理,为老年病人成功地完成伽玛刀治疗提供了有效地保证.现将体会报告如下.

伽玛刀治疗后的垂体卒中3例

INTRODUCTIONGamma knife has become an effective method in auxiliary treatment of neural surgery with developing of therapeutic technique.But reports about pituitary apoplexy after gamma knife treatment are quite few.From August 1998 to February 2002,156 patients with pituitary adenoma were treated with gamma knife among which pituitary apoplexy occurred in 3 cases(1.9% ),the following is the report.

脑型血吸虫病误行伽玛刀治疗1例

脑型血吸虫病是一种异位血吸虫病,由于临床表现复杂, 临床医务人员对其认识不足且缺乏警惕,易引起误诊误治.

Objective:To explore the clinical effect and significance of adoptive immunotherapy of dendritic cell and cytokine-induced killer cell (DC-CIK) combined with the gamma knife in the treatment of middle and advanced hepatic carcinoma.Methods:42 patients with the middle and advanced primary hepatic carcinoma were randomly divided into two groups: 20 cases in the combination group were given the adoptive immunotherapy of DC-CIK cells and gamma knife radiotherapy; 22 cases in the control group were only given the gamma knife radiotherapy. The short-term effect, quality of life, overall survival and toxic and side effects were compared between two groups after the operation.Results: 3 months after the treatment, the short-term effect of combination group and control group was 70% and 54.5% respectively (P<0.05). Patients in the combination group performed better in the overall survival, change of T-cell subsets, PS score, decrease rate of AFP and degree of liver function than the control group, while the adiodermatitis at II and over and bone marrow suppression were also better than the control group. Conclusion:The adoptive immunotherapy of DC-CIK cells combined with the gamma knife in the treatment of middle and advanced hepatic carcinoma can prolong the overall survival, improve the quality of life, reduce the toxic and side effect and effectively promote the short-term clinical effect for patients.