Abstract：
BACKGROUND: Cardiac angiosarcoma is a very rare disease. As a result of their nonspecific presentation symptoms, and the lack of consensus in treatment, caution should be taken in both diagnosis and treatment. The role of radiotherapy (RT) is debatable due to the continuous movement of the heart, which makes it difficult to safely deliver high radiation doses to the target volume.
METHODS: The case of a 16-year-old boy with cardiac angiosarcoma that recurred one year after surgery and was treated with chemotherapy is presented. The patient received high field 1.5-Tesla (magnetic resonance) MR-Linac treatment in 5 fractions with a dosage of 25 Gy to the tumor bed and 30 Gy to the recurrent nodules using the simultaneous integrated boost technique. The patient tolerated the treatment well and had stable disease two months later.
CONCLUSIONS: MR-guided radiotherapy, particularly in the case of cardiac malignancies, allows for direct tumor visualization with high soft tissue image resolution capacity. Furthermore, modern RT techniques allow for the full therapeutic window to be used by achieving superior dose distributions, allowing for dose escalation strategies with tolerable toxicity rates.
CONCLUSIONS: Magnetic resonance guided RT allows direct visualization of the target during treatment delivery, allowing for higher-dose administration with less damage to healthy tissue near the tumor. This treatment strategy is a viable option in selected patients with cardiac angiosarcoma.
METHODS: The case of a 16-year-old boy with cardiac angiosarcoma that recurred one year after surgery and was treated with chemotherapy is presented. The patient received high field 1.5-Tesla (magnetic resonance) MR-Linac treatment in 5 fractions with a dosage of 25 Gy to the tumor bed and 30 Gy to the recurrent nodules using the simultaneous integrated boost technique. The patient tolerated the treatment well and had stable disease two months later.
CONCLUSIONS: MR-guided radiotherapy, particularly in the case of cardiac malignancies, allows for direct tumor visualization with high soft tissue image resolution capacity. Furthermore, modern RT techniques allow for the full therapeutic window to be used by achieving superior dose distributions, allowing for dose escalation strategies with tolerable toxicity rates.
CONCLUSIONS: Magnetic resonance guided RT allows direct visualization of the target during treatment delivery, allowing for higher-dose administration with less damage to healthy tissue near the tumor. This treatment strategy is a viable option in selected patients with cardiac angiosarcoma.
摘要：
背景：心脏血管肉瘤是一种非常罕见的疾病。由于他们的非特异性表现症状，在治疗上缺乏共识，在诊断和治疗上应谨慎。由于心脏的持续运动，放射治疗（RT）的作用值得商榷，这使得很难安全地将高辐射剂量传递到目标体积。
方法：介绍一例16岁男孩心脏血管肉瘤，术后1年复发，接受化疗治疗。患者使用同步集成增强技术，分5次接受高场1.5特斯拉（磁共振）MR-Linac治疗，对瘤床的剂量为25Gy，对复发结节的剂量为30Gy。患者耐受良好，两个月后病情稳定。
结论：MR引导放疗，特别是在心脏恶性肿瘤的情况下，允许直接肿瘤可视化与高软组织图像分辨率能力。此外，现代RT技术允许通过实现优异的剂量分布来使用完整的治疗窗口，允许具有可耐受毒性率的剂量递增策略。
结论：磁共振引导的RT可以在治疗期间直接显示目标，允许高剂量给药，对肿瘤附近的健康组织损伤较小。这种治疗策略对于某些心脏血管肉瘤患者是可行的选择。
方法：介绍一例16岁男孩心脏血管肉瘤，术后1年复发，接受化疗治疗。患者使用同步集成增强技术，分5次接受高场1.5特斯拉（磁共振）MR-Linac治疗，对瘤床的剂量为25Gy，对复发结节的剂量为30Gy。患者耐受良好，两个月后病情稳定。
结论：MR引导放疗，特别是在心脏恶性肿瘤的情况下，允许直接肿瘤可视化与高软组织图像分辨率能力。此外，现代RT技术允许通过实现优异的剂量分布来使用完整的治疗窗口，允许具有可耐受毒性率的剂量递增策略。
结论：磁共振引导的RT可以在治疗期间直接显示目标，允许高剂量给药，对肿瘤附近的健康组织损伤较小。这种治疗策略对于某些心脏血管肉瘤患者是可行的选择。
