据报道,一名50岁男子在左侧腹侧患有横纹肌肉瘤转移灶。为了局部控制病变,患者接受了50.4Gy放疗和伴随化疗。使用Tri-60-Co磁共振混合放射治疗装置进行治疗,并将呼吸门控协议应用于不同的呼吸阶段(自由呼吸,深呼吸保持和最终呼气保持)。计算了三个强度调制放射治疗(IMRT)计划,并且由于不存在PTV覆盖差异和较好的有风险的器官(即肾脏),最终选择了最终呼气呼吸保持计划。该病例报告表明,在MRI引导的呼吸门控放射治疗中避免处于危险中的器官是可行的,并且在保留处于危险中的器官具有最大的剂量学或临床重要性时尤其有利。
The
case of a 50-year-old man affected by a rhabdomiosarcoma metastatic lesion in the left flank Is reported. The patient was addressed to 50.4 Gy radiotherapy with concomitant chemotherapy in order to locally control the lesion. A Tri-60-Co magnetic resonance hybrid radiotherapy unit was used for treatment delivery and a respiratory gating protocol was applied for the different breathing phases (Free Breathing, Deep Inspiration Breath Hold and Final Expiration Breath Hold). Three intensity modulated radiation therapy (IMRT) plans were calculated and Final Expiration Breath Hold plan was finally selected due to the absence of PTV coverage differences and better organs at risk sparing (i.e. kidneys). This
case report suggests that organs at risk avoidance with MRI-guided respiratory-gated Radiotherapy is feasible and particularly advantageous whenever sparing the organs at risk is of utmost dosimetric or clinical importance.