磁共振成像导向放射治疗脊髓大病:临床经验和技术提示
Angela Romano1, Lorenzo Placidi1, Luca Boldrini1
1Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Advances in radiation oncology
|October 10, 2024
概括
用磁共振引导放射治疗 (MRgRT) 进行脏辐射 (SI) 有效地减少了脏大小,并缓解了骨髓纤维化 (MFI) 和骨髓质/骨髓扩散性瘤 (MDS/MPN) 患者的症状. 这种技术提供了一个安全和可行的替代方案,以脊髓切除术.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 血液学 血液学 血液学
背景情况:
- 脊髓大是慢性淋巴细胞和骨髓细胞恶性瘤的常见并发症.
- 脊髓切除术虽然有效治疗症状性脊髓大病,但存在重大风险.
- 在这种情况下,放射治疗 (RT) 传统上用于息护理.
研究的目的:
- 调查磁共振引导辐射疗法 (MRgRT) 对脏辐射 (SI) 的疗效和安全性.
- 在被诊断患有骨髓纤维化 (MFI) 和骨髓位/骨髓扩散性新生瘤 (MDS/MPN) 的患者中评估MRgRT SI.
主要方法:
- 2018年至2022年期间接受MRgRT SI的MFI和MDS/MPN患者的单中心回顾性分析.
- 治疗涉及十个1Gy分数,以小的差距输送到脏.
- 适应性策略 (在线/离线) 被采用,以尽量减少剂量到周围的健康器官.
主要成果:
- 所有12名患者都没有中断地完成SI;根据需要进行支持性输血.
- 大多数患者观察到显著的症状缓解 (疼痛,胃肠道问题).
- 脊髓体积的平均减少为53.61%,尾延伸减少了77.78%.
结论:
- 对于MFI和MDS/MPN患者来说,MRgRT SI是一种可行的治疗方法,可提供症状缓解和大大减少脏体积.
- 适应性规划和实时验证使得精确的准和减少对健康组织的暴露.
- 需要进一步的前性研究来证实长期的疗效和安全性.
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