Image‐guided and intensity‐modulated radiosurgery for patients with spinal metastasis

作者：Samuel Ryu, F.-F. Yin, Jack P. Rock, Jingeng Zhu, Archie Chu, Eduard Kagan, Lisa R. Rogers, Munther Ajlouni, Mark L. Rosenblum, Jae Ho Kim · 发表于：Cancer · 年份：2003 · DOI：10.1002/cncr.11296 · 被引用次数：332 · 研究领域：Management of metastatic bone disease、Advanced Radiotherapy Techniques、Spinal Fractures and Fixation Techniques

BACKGROUND: Radiosurgery can deliver a single, large radiation dose to a localized tumor using a stereotactic approach and hence, requires accurate and precise delivery of radiation to the target. Of the extracranial organ targets, the spine is considered a suitable site for radiosurgery, because there is minimal or no breathing-related organ movement. The authors studied spinal radiosurgery in patients with spinal metastases to determine its accuracy and precision. METHODS: The spinal radiosurgery program was based on an image-guided and intensity-modulated, shaped-beam radiosurgical unit. It is equipped with micromultileaf collimators for beam shaping and radiation intensity modulation and with a noninvasive, frameless positioning device that uses infrared, passive marker technology together with corroborative image fusion of the digitally reconstructed image from computed tomography (CT) simulation and orthogonal X-ray imagery at the treatment position. These images were compared with the port films that were taken at the time of treatment to determine the accuracy of the isocenter position. Clinical feasibility was tested in 10 patients who had spinal metastasis with or without spinal cord compression. The patients were treated with fractionated external beam radiotherapy followed by single-dose radiosurgery as a boost (6-8 grays) to the most involved portion of the spine or to the site of spinal cord compression. RESULTS: The accuracy for the isocenter was within 1.36 mm...