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RapidArc与Novalis Knife在多发脑转移瘤SRS中的剂量学比较 被引量:2
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作者 戴鹏 张平 +5 位作者 罗龙辉 邓官华 赖名耀 山常国 黄庆 蔡林波 《中国医学物理学杂志》 CSCD 2020年第10期1242-1247,共6页
目的:比较基于多叶准直器的RapidArc与基于圆形限光筒的Novalis Knife在多发脑转移瘤立体定向放射外科(SRS)中的剂量学差异。方法:选取10例已进行Novalis Knife治疗的多发脑转移瘤患者(转移瘤3~5个/人),共37个转移瘤。重新设计单中心、... 目的:比较基于多叶准直器的RapidArc与基于圆形限光筒的Novalis Knife在多发脑转移瘤立体定向放射外科(SRS)中的剂量学差异。方法:选取10例已进行Novalis Knife治疗的多发脑转移瘤患者(转移瘤3~5个/人),共37个转移瘤。重新设计单中心、非共面4弧的RapidArc SRS计划,靶区处方剂量统一为16 Gy。比较Novalis Knife计划和RapidArc SRS计划中靶区的剂量适形度指数和均匀性指数、靶区周围剂量梯度指数、正常脑组织等剂量线体积(V16、V12、V9、V6、V3)以及治疗所需的机器跳数。结果:RapidArc SRS计划相较于Novalis Knife计划,适形度指数更接近于1(0.79±0.10 vs 0.50±0.22,P=0.000),均匀性指数更接近于0(0.07±0.01 vs 0.15±0.07,P=0.000),但靶区周围剂量梯度指数较大(15.92±12.43 vs 5.05±3.53,P=0.000)。对于正常脑组织等剂量线体积,RapidArc SRS计划中V16明显小于Novalis Knife计划(P=0.005);两计划的V12、V9无明显差异(P=0.445,0.059);而RapidArc SRS计划中V6、V3明显大于Novalis Knife计划(P=0.005,0.005)。RapidArc SRS计划的机器跳数明显少于Novalis Knife计划(P=0.005)。结论:RapidArc SRS计划通过设置单一治疗等中心可实现颅内多个转移瘤的同步放射外科治疗,具有更高的靶区剂量适形度及均匀性;但靶区周边剂量跌落陡度不及Novalis Knife计划,正常脑组织低剂量受照范围较大。治疗依从性较差的多发脑转移患者可考虑选择治疗效率更高的RapidArc技术,并根据临床实际情况调整剂量分割模式,以减少放射损伤风险。 展开更多
关键词 多发脑转移瘤 立体定向放射外科 RAPIDARC novalis Knife 剂量学比较
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Trope, Reason, and Affirmation in Nietzsche's and Novalis' Theories of Language
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作者 Anna Ezekiel 《Journal of Philosophy Study》 2012年第10期743-753,共11页
This paper analyzes the role of six tropes (metonymy, synecdoche, metaphor, analogy, allegory, and irony) in Nietzsche's and Novalis' writings on language and cognition, using the comparison to show how a negative... This paper analyzes the role of six tropes (metonymy, synecdoche, metaphor, analogy, allegory, and irony) in Nietzsche's and Novalis' writings on language and cognition, using the comparison to show how a negative element in Nietzsche's attitude towards the tropic nature of cognition underlies well-known problems in his response to nihilism. These problems include ambiguities in Nietzsche's attitude to truth, and the question of how well he can carry through his project of affirming the individual on the basis of a creative reinterpretation of experience. I maintain that Novalis understands language and cognition to be tropic in a similar way as Nietzsche does, and that these writers provide similar critiques of discursive reason on the basis of what they view as its stultifying rigidity and misleading claims to a "literal" form of objectivity. However, I argue that Novalis avoids Nietzsche's difficulties by maintaining that a creative element in cognition does not rule out a variant of a correspondence notion of truth. Although Novalis' account thus falls foul of Nietzsche's goal of providing an immanent affirmation of human experience, the comparison shows that a Nietzschean attempt to provide a convincing model of individual self-affirmation should integrate a more positive role for trope, which can support a satisfying conception of the value of human creativity. 展开更多
关键词 NIETZSCHE novalis AFFIRMATION trope METAPHOR TRUTH creativity
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