立體定位放射手術之腦瘤治療

Stereotactic Radiosurgery in the Management of Brain Tumors

蘇泉發(Chain-Fa Su) ； 哈鐵木爾(Tomor Harnod) ； 陳新源(Shin-Yuan Chen) ； 邱琮朗(Tsung-Lang Chiou) ； 陳武福(Wu-Fu Chen) ； 廖明雄(Ming-Hsiung Liaw) ； 許文林(Wen-Lin Hsu) ； 林欣榮(Shinn-Zong Lin)

《慈濟醫學雜誌》 15卷5期 (2003/10) Pp. 281-292

https://doi.org/10.6440/TZUCMJ.200310.0281

摘要

立體定位放射手術是結合腦外科醫師、放射腫瘤醫師、醫學物理師及工程師團隊經營的微侵犯性技術。自1951年Leksell醫師首度描述立體定位放射手術以來，至今全世界已經超過二十萬接受腦部立體定位放射手術之治療。由於過去數年電腦科技突飛猛進，間接帶動神經影像醫學之快速成長，直接影響立體定位放射手術的技行，因此，最近二十年來，許多不同形式的立體定位放射手術技術也逐漸更新，另一方面，立體定位放射手術對血管性腦疾及腦瘤的長期追蹤結果，也逐漸明朗，使得原先以開顱手術為主的顱底手術轉為微侵犯型之立體定位放射手術，在此回顧文章中，作者闡述最近立體定位放射手術的新技術及近年來臨床長期追蹤的成果，因此也釐清出此技術之治療準則。

關鍵字

伽傌刀 ； 放射手術 ； 腦膜瘤 ； 膠質母細胞瘤 ； 神經纖維瘤

並列摘要

Stereotactic radiosurgery is a minimally invasive technique performed by a team composed of neurosurgeons, radia-tion oncologists, and medical physicists. More then 200,000 patients throughout the world have undergone radiosur-gery since Lars and Leksell first described the technique in 1951. In the past few decades, stereotactic radiosurgery has progressed from a concept to a fully developed neurosurgical subspecialty after concomitant advances in imaging computer technologies. No other neurosurgical procedures have undergone such rapid and sustained growth and have received such wide spread application. In the past 20 years, in addition to technological improvements, the results of long-term follow-up of stereotactic radiosurgy have been published. They prove that for some benign and metastatic brain tumors the tumor control rate is satisfactory for neurosurgeons and patients. Therefore, some surgically aggres-sive management of deeply seated brain tumors such as skull base tumor has shifted to stereotactic radiosurgery if the tumor is small enough to receive this treatment, usually less than 3 cm. In this review article, the author describes recent advancements in stereotactic radiosurgical techniques and clinical results reported in the international literature. Indications and principles are then clarified.

並列關鍵字

gamma knife ； radiosuregery ； meningioma ； glioblastoma ； schwannoma