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目的探讨髓母细胞瘤及分化差的室管膜细胞瘤的全中枢系统照射时照射野的设置及技术要点。方法患者取俯卧位,利用大小合适的真空负压垫固定患者体位,头部垫船型枕,用面罩固定。通过CT模拟定位定全颅野和全脊髓野。采用X线全脑照射和电子线全脊髓照射。结果用此种方法在全脑和脊髓内得到比较理想的剂量分布,用电子线照射脊髓可以根据患者脊髓深度选择适当能量的电子线来满足脊髓所需剂量,而脊髓前方的正常组织所受剂量相对较少,患者的放射反应较轻,初步临床观察结果满意。结论 X线全脑及电子线全脊髓照射是目前综合治疗髓母细胞瘤及分化差室管膜细胞瘤的的主要方法之一,而放疗摆位及照射技术应予重视。
Objective To investigate the setting and technical points of irradiation field of medulloblastoma and poorly differentiated ependymoma in the central nervous system. Methods The patient was taken prone position, the use of appropriate size of the vacuum negative pressure pad to fix the patient’s position, the head cushion type pillow, fixed with a mask. Whole-cranial and total spinal fields were determined by CT simulation. X-ray whole brain irradiation and electron beam whole spinal cord irradiation. Results With this method, the ideal dose distribution in the whole brain and spinal cord was obtained. The electron beam irradiated the spinal cord can select the appropriate dose of spinal cord according to the depth of the spinal cord, and the dose of the normal tissue in front of the spinal cord Relatively few, the patient’s radiation response is light, the initial clinical findings are satisfactory. Conclusions Whole spinal cord irradiation of whole brain and electron beam is one of the main methods for the comprehensive treatment of medulloblastoma and poorly differentiated ependymocytoma. Radiotherapy placement and irradiation techniques should be emphasized.