PDF(Pubmed)
Abstract：
UNASSIGNED: The stomach is one of the most deformable organs. Its shape can be easily affected by breathing movements, and daily diet, and it also varies when the body position is different. The susceptibility of stomach has made it challenging to treat gastric cancer using the conventional image-guided radiotherapy, i.e., the techniques based on kilovoltage X-ray imaging. The magnetic resonance imaging guided radiotherapy (MRgRT) is usually implemented using a hybrid system MR-LINAC. It is feasible to implement adaptive radiotherapy using MR-LINAC for deformable organs such as stomach. In this case report, we present our clinical experience to treat a gastric cancer patient using MR-LINAC.
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.
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.
摘要：
■胃是最容易变形的器官之一。它的形状很容易受到呼吸运动的影响，和日常饮食，当身体位置不同时，它也会变化。胃的敏感性使得使用传统的图像引导放射治疗胃癌具有挑战性，即，基于千伏X射线成像的技术。通常使用混合系统MR-LINAC来实现磁共振成像引导放射治疗(MRgRT)。使用MR-LINAC对胃等可变形器官实施自适应放射治疗是可行的。在这个案例报告中,我们介绍了我们使用MR-LINAC治疗胃癌患者的临床经验.
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。
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。
