• 作者：Jean A. Laissue¹ ; ^{laissue@pathology.unibe.ch} ; Hans Blattmann² ; Daniel N. Slatkin³
• 关键词：Alban K&ouml ; hler ; rä ; umliche Fraktionierung ; R&ouml ; ntgen-Tiefentherapie ; Gitter ; Sieb ; mikroplanare Synchrotron-R&ouml ; ntgenstrahlen
• 刊名：Zeitschrift fü ; r Medizinische Physik
• 出版年：2012
• 期刊代码：20_09393889
• 类别：et
• 出版时间：June, 2012
• 卷：22
• 期：2
• 页码：90-99
• 文件大小：162 K

Grid (or sieve) therapy (鈥濭itter-鈥?oder 鈥濻iebtherapie鈥?, spatially fractionated kilo- and megavolt X-ray therapy, was invented in 1909 by Alban K枚hler, a radiologist in Wiesbaden, Germany. He tested it on several patients before 1913 using approximately 60-70 kV Hittorf-Crookes tubes. K枚hler pushed the X-ray tube's lead-shielded housing against a stiff grid of 1 mm-square iron wires woven 3.0-3.5 mm on center, taped tightly to the skin over a thin chamois. Numerous islets unshielded by iron in the pressure-blanched skin were irradiated with up to about 6 erythema doses (ED). The skin was then thoroughly cleansed, disinfected, and bandaged; delayed punctate necrosis healed in several weeks. Although grid therapy was disparaged or ignored until the 1930s, it has been used successfully since then to shrink bulky malignancies. Also, advanced cancers in rats and mice have been mitigated or ablated using K枚hler's concept since the early 1990s by unidirectional or stereotactic exposure to an array of nearly parallel microplanar (25-75 渭m-wide) beams of very intense, moderately hard (median energy approximately 100 keV) synchrotron-generated X rays spaced 0.1-0.4 mm on center. Such beams maintain sharp edges at high doses well beneath the skin yet confer little toxicity. They could palliate some otherwise intractable malignancies, perhaps in young children too, with tolerable sequelae. There are plans for such studies in larger animals.