Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan;
Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
In Vivo. 2022 May-Jun;36(3):1523-1526. doi: 10.21873/invivo.12862.
BACKGROUND/AIM: This is a report of the first clinical implementation of Tc-labeled diethylene triamine pentaacetate-galactosyl human serum albumin (Tc-GSA) single-photon emission computed tomography (SPECT) image-guided inverse planning into palliative radiotherapy (RT) for diffuse liver metastases.
A 48-year-old man developed chemo-refractory diffuse liver metastases from thymic carcinoma characterized by abdominal pain and distension. Palliative RT was performed with a total dose of 20 Gy in five fractions using double arc volumetric modulated arc therapy to reduce the dose to functional liver defined by Tc-GSA SPECT images. His symptoms were immediately relieved after RT and did not experience radiation-induced liver disease. Both Functional Assessment of Cancer Therapy (FACT)-G and FACT-Hep total scores improved after 2 weeks of RT initiation and did not become worse than baseline scores.
The Tc-GSA SPECT image-guided palliative RT is an effective and safe treatment for patients with diffuse liver metastases.
背景/目的：这是首例 Tc 标记的二乙烯三胺五乙酸半乳糖基人血清白蛋白（Tc-GSA）单光子发射计算机断层扫描（SPECT）图像引导调强适形放射治疗（RT）用于治疗弥漫性肝转移的临床应用报告。
一名 48 岁男性患有胸腺癌引起的化疗耐药性弥漫性肝转移，表现为腹痛和腹胀。采用双弧容积调强弧形治疗技术，以 Tc-GSA SPECT 图像定义的功能肝为目标，分 5 次给予总剂量 20 Gy 的姑息性 RT。RT 后患者的症状立即得到缓解，未出现放射性肝损伤。RT 开始后 2 周，癌症治疗功能评估（FACT）-G 和 FACT-Hep 总分均提高，且未低于基线评分。
Tc-GSA SPECT 图像引导的姑息性 RT 是治疗弥漫性肝转移患者的一种有效且安全的治疗方法。
