UNASSIGNED: The patient is a 58-year-old male who started having black stools with no apparent cause a year ago. Gastroscopy result showed pancreatic cancer, pathology: adenocarcinoma on gastric cancer biopsy, adenocarcinoma on gastric body minor curvature biopsy. The patient was diagnosed with gastric cancer (adenocarcinoma, cTxN+M1, stage IV, HER-2 positive). The patient was treated in 25 fractions with radiotherapy using MR-LINAC with online adaptive treatment plans daily. The target area in daily MR images varied considerably when compared with the target area on the CT simulation images. During the course of treatment, there have even been instances where the planned target area where the patient received radiotherapy did not cover the lesion of the day.
UNASSIGNED: Online adaptive MRgRT can be a meaningful innovation for treating malignancies in the upper abdomen. The results in the current study are promising and are indicative for further optimizing online adaptive MRgRT in patients with inoperable tumors of the upper abdomen.
患者是一名58岁的男性,一年前开始出现黑色大便,没有明显的病因。胃镜检查结果显示胰腺癌,病理:腺癌对胃癌活检,胃体小曲活检腺癌。患者被诊断为胃癌(腺癌,cTxN+M1,阶段IV,HER-2阳性)。每天使用MR-LINAC和在线适应性治疗计划,对患者进行25次放射治疗。与CT模拟图像上的目标区域相比,每日MR图像中的目标区域差异很大。在治疗过程中,甚至有患者接受放疗的计划靶区没有覆盖当天的病灶.
■在线适应性MRgRT可以成为治疗上腹部恶性肿瘤的有意义的创新。当前研究的结果是有希望的,并且指示进一步优化上腹部不可手术肿瘤患者的在线自适应MRgRT。