Abstract：
Historically, respiratory induced motion has made renal radiotherapy difficult due to the potential risk of additional toxicities to the patient due to tumor movement. The use of deep inspiration breath holds (DIBH) in congruence with magnetic resonance guided radiotherapy (MRgRT) may be an effective method to manage tumor and organ at risk (OAR) motion and deliver radiation safer and more effectively. The purpose of this case study was to evaluate the effectiveness of DIBH in sparing radiation dose to colon and small bowel during MRgRT of right sided renal cell carcinoma (RCC). The goals were to reduce radiation dose to colon and small bowel during RCC treatment with these motion management techniques. A retrospective case study of a patient with oligoprogression in the postoperative renal fossa was found to be a candidate for DIBH using MRgRT. Treatment planning called for motion management and real-time imaging in order to safely treat the tumor volume. Results were evaluated by the achievement of specific dosimetric criteria and tolerances and the regression of disease in the renal fossa. The use of real-time imaging and simultaneous motion management proved to be effective tools for the treatment of RCC. This radiation therapy treatment resulted in the elimination of malignancy at the primary site of disease.
摘要：
历史上,呼吸诱发的运动使肾脏放疗变得困难，因为肿瘤运动会给患者带来额外的毒性。与磁共振引导放射治疗（MRgRT）一致使用深吸气屏气（DIBH）可能是一种有效的方法，可以管理肿瘤和危险器官（OAR）运动并更安全，更有效地提供辐射。本病例研究的目的是评估DIBH在右侧肾细胞癌（RCC）的MRgRT期间减少对结肠和小肠的辐射剂量的有效性。目标是使用这些运动管理技术在RCC治疗期间减少对结肠和小肠的辐射剂量。一项回顾性病例研究发现，使用MRgRT对术后肾窝少发的患者进行了DIBH的候选治疗。治疗计划需要运动管理和实时成像，以便安全地治疗肿瘤体积。通过实现特定的剂量测定标准和耐受性以及肾窝疾病的消退来评估结果。使用实时成像和同步运动管理被证明是治疗RCC的有效工具。这种放射疗法治疗导致消除了疾病原发部位的恶性肿瘤。
