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首页> 外文期刊>Surgical neurology >Linear accelerator thalamotomy.
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Linear accelerator thalamotomy.

机译：线性加速器丘脑。

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摘要

BACKGROUND: The capability of performing functional radiosurgery lesions in the brain using a dedicated linear accelerator (LINAC) have not yet been demonstrated. This study evaluates modern LINAC technology for the creation of a sharp, small and functionally eloquent lesion in the thalamus. METHODS: Three patients underwent thalamotomy using a dedicated linear accelerator to radiosurgery, 2 females and 1 male, ages were 52, 53, and 73 years. Two patients presented with unilateral poststroke central pain and 1 with unilateral upper extremity pain secondary to metastatic infiltration of the brachial plexus. Maximal doses varied from 150 to 200 Gy, delivered by a 5-mm diameter collimator and 5 to 8 noncoplanar arcs evenly distributed. RESULTS: All patients gained substantial relief of their pain. They were able to reduce their medications and improve their activity levels. The patient with end-stage metastatic disease died of his malignancy 2 weeks after the treatment. One patient presented with recurrence of the pain 4 months after the treatment. No clinical complications were noticed. CONCLUSIONS: A dedicated linear accelerator is able to perform a precise and circumscribed lesion in the thalamus for pain control. Moreover, it proved to be safe, because no complications were observed. For patients using chronic anticoagulant therapy or with severe disabilities caused by cardiac, pulmonary or malignant diseases, this technique represents an alternative of treatment to radiofrequency thalamotomy.
机译：背景：尚未证明使用专用线性加速器（LINAC）在大脑中执行功能性放射外科手术损伤的能力。这项研究评估了现代LINAC技术在丘脑中形成尖锐，小而功能丰富的病变的能力。方法：3例患者使用专用的直线加速器进行放射治疗，分别为2名女性和1名男性，年龄分别为52、53和73岁。 2例因臂丛神经转移性浸润继发中风后单侧疼痛和1例上肢单侧疼痛。最大剂量从150到200 Gy不等，由直径为5毫米的准直器和5至8个非共面弧均匀分布。结果：所有患者的疼痛得到了实质性缓解。他们能够减少用药并提高活动水平。治疗终末期转移性疾病的患者在治疗后2周死于恶性肿瘤。一名患者在治疗后4个月出现疼痛复发。没有发现临床并发症。结论：专用的线性加速器能够在丘脑中执行精确的界限性病变，以控制疼痛。此外，由于未观察到并发症，因此被证明是安全的。对于使用慢性抗凝治疗或因心脏，肺部或恶性疾病引起的严重残疾的患者，此技术代表了射频丘脑切开术的替代治疗方法。

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