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《朱錫旭 Advances in Radiosurgery for Lung cancer》由會員上傳分享，免費在線閱讀，更多相關內(nèi)容在學術論文-天天文庫。
1、肺癌立體定向放射外科新進展南京軍區(qū)南京總醫(yī)院放射治療科朱錫旭AdvancesinRadiosurgeryforLungCancerZHUxixuDepartmentofRadiationOncologyNanjingGeneralHospitalDiseasedistribution?2500patientsweretreatedwithCyberknifefrom2009to2014BrainLungLiverPancreasSpinalLesionOthersOutline?Definitionofradiosurgery?Radi
2、osurgerytechnology?Roleofradiosurgeryinthetreatmentofearly–stagelungcancerdetectedbyscreen?RadiosurgryforlungcancerinpatientswithsevereCOPD?RadiosurgeryforcentrallungcancerWhatisRadiosurgery?Preciseirradiation?Smallnumber(onetofive)?High-dosefractions（≥10Gy/fx）Howtocomet
3、rueTechniquesandtechnology?Cyberknife?Tomotherapy?GantrybasedLA?γKnife?Protontherapy?ParticaltherapyChallengestotreatmentdelivery?RespiratorymotionGatedbreathingcontrolBreath-holdTumourtracking4DCT?Set-uperrorsIGRTGantrybasedradiosurgeryandCyberknifeTUMORTUMORRoboticster
4、eotacticradiosurgerysystem-CyberKnifemaximizedose,minimizesideeffects,maximizepatientcomfortEssenceofradiosurgery?Accuratehit?Thehighdosesperfractionstrivetowardsanablativetumoureffect?WhereasminimizingtheradiationdoseisdeliverytoadjacentnormaltissuesAschematicoftheproce
5、ssandRequirementsforradiosurgery?Effectivepatientimmobilisation?Precisetargetlocalisation(differentimagingmodalities)?Sophisticatedplanningsoftware?Accuratetreatmentdelivery?Abilitytoproduceasteepisodosegradient?Extracraniallesionspose(tumourandcriticalorganmotion)Early-
6、stagelungcancerdetectedbyscreening?ScreeningforlungcancerusingCTshowedasurvivalbenefit?Areductioninlung-cancer-relatedmortalityof20·0%whenusinglow-doseCTinsteadofchestradiography(NLST)?Screenpositivitywasdefinedbyagreatestnodulediameterof4mmorlarger,and24%ofallCTscreensw
7、erepositive?AlmostallofthesearebenignHowtodiagnosis?InvasivediagnosticproceduresTrans-thoracicneedlebiopsySurgery?Volumedoublingtime(VDT)?18F-FDGPETSurgeryforscreendetectedtumours?Ifmalignancyisdiagnosedonfrozensection,ananatomicalresection,withanadequatelymphnodedissect
8、ion?LocalrecurrenceincreasedbythreetimeswithlimitedresectioncomparedwithlobectomyinpatientswithstageIAN
