BalajiSubramanian Sitaraman, Sathiya Krishnamoorthy, Balaji Karunakaran, Thirunavukarasu Moorthi, Phanikiran Surparaju, Rela Mohamed
Department of Radiation Oncology, Gleneagles Global Health City, Chennai, Tamil Nadu, India.
Department of Spine Surgery, Gleneagles Global Health City, Chennai, Tamil Nadu, India.
Rep Pract Oncol Radiother. 2021 Dec 30;26(6):1060-1065. doi: 10.5603/RPOR.a2021.0098. eCollection 2021.
Modern radiotherapy machines with refinements in planning software and image-guidance apparatuses have made stereotactic body radiotherapy (SBRT) more widely available as an effective tool in the management of spine metastases. In conventional palliative radiotherapy, the aim has traditionally been pain relief and short-term local control. In contrast, SBRT aims to deliver an ablative dose to enhance local control, with a smaller number of fractions while sparing the organs at risk (OAR), especially the spinal cord. Recently, trials have asserted the role of spine SBRT as an effective modality for durable local control, in addition to achieving pain relief. The quality of evidence for spine SBRT data is maturing, while prospective published trials on re-irradiation SBRT in spine remain sparse. The purpose of the present case report is to share the challenges faced while salvaging a dorsal spine metastasis and ablating a new right adrenal metastatic lesion in proximity of the transplanted liver.
随着计划软件和图像引导设备的改进，现代放射治疗机器已使立体定向体部放射治疗（SBRT）作为脊柱转移瘤管理中的一种有效工具得到更广泛应用。在传统姑息性放射治疗中，传统目标一直是缓解疼痛和实现短期局部控制。相比之下，SBRT旨在给予消融剂量以增强局部控制，分割次数更少，同时保护危及器官（OAR），尤其是脊髓。最近，试验证实了脊柱SBRT作为实现持久局部控制以及缓解疼痛的一种有效方式的作用。脊柱SBRT数据的证据质量正在成熟，而关于脊柱再程照射SBRT的前瞻性发表试验仍然很少。本病例报告的目的是分享在挽救胸椎转移瘤并消融移植肝脏附近新出现的右肾上腺转移瘤时所面临的挑战。
