Sia Joseph, Glance Simon, Chandran Sujievvan, Vaughan Rhys, Hamilton Chris
Department of Radiation Oncology, Austin Health, Heidelberg.
J Med Imaging Radiat Oncol. 2013 Oct;57(5):626-8. doi: 10.1111/1754-9485.12084.
The use of fiducial markers (FM) in image-guided radiotherapy (IGRT) to increase treatment precision is emerging for upper gastrointestinal malignancies. To our knowledge there is no data beyond technical reports for the use of FMs in IGRT for gastric cancers in the current literature. We report a case of an 89-year old gentleman with localised gastric cancer who was deemed unfit for surgery and chemotherapy. He had FMs inserted endoscopically around the tumour via ultrasound guidance and received radiotherapy with a high-dose palliative intent via a two-phase technique to 54 Gy in 30 fractions with IGRT. The use of FMs allowed confidence in tumour delineation and together with IGRT enabled precise and safe delivery of a higher dose. The patient tolerated the treatment without significant toxicity and had no evidence of residual or recurrent tumour 12 months following radiotherapy. The use of FMs with IGRT in upper gastrointestinal malignancies warrants further collaborative studies.
在图像引导放射治疗（IGRT）中使用基准标记物（FM）以提高治疗精度，这在治疗上消化道恶性肿瘤方面正逐渐兴起。据我们所知，目前文献中除了技术报告外，没有关于FM在胃癌IGRT中应用的数据。我们报告了一例89岁的局限性胃癌男性患者，他被认为不适合手术和化疗。通过超声引导，在内镜下于肿瘤周围植入FM，然后采用两阶段技术，以高剂量姑息治疗为目的，在IGRT下给予54 Gy，分30次照射。FM的使用使肿瘤轮廓勾画更有信心，并且与IGRT一起能够精确、安全地给予更高剂量。患者耐受了治疗，未出现明显毒性，放疗后12个月无残留或复发肿瘤迹象。在治疗上消化道恶性肿瘤时，FM与IGRT联合使用值得进一步开展合作研究。
