脳深部のMalignant gliomaに対するCT-guided stereotactic brachytherapy—Double-catheter after-loading法による組織内大量照射（第1報）

CT-guided Stereotactic Brachytherapy for Deep-seated Mahgnant Gliomas: Interstitial irradiation by double-catheter after-loading method

　I．はじめに　悪性脳腫瘍の治療には，従来，外科的治療，放射線治療，化学療法，免疫療法，温熱療法などが併用されてきたが，治療成績は満足すべきものとはいえない^{8,13,16，17）}．

　深部悪性脳腫瘍に対しては，定位脳手術と放射線治療を組み合わせた方法で，Mundinger^15）は組織内照射を行ってきた．近年，より的確なradiosurgcryとして，computed tomography（CT）と定位脳手術を組み合わせ，局所の照射線量をあらかじめ正確に設定できるafter-loading法で組織内照射が行われるようになった^{3-5,6,9-11,14）}．

CT-guided stereotactic brachytherapy has been performed for the deep-seated malignant gliomas using the double-catheter after-loading method. The catheter system consists of two coaxial poly-ethylene tubes with closed tips. The outer catheter is 3.0 ram in outer diameter and 2.4 mm in inner diameter. The inner catheter is 2.0 mm in outside diameter and 1.4 mm in inside diameter, and con-tains the radioactive sources.

Localization of the target volume is determined by the preoperative findings of computed tomography (CT), magnetic resonance imaging (MRI), and cere-bral angiography.