GenesisCare, Sydney, New South Wales, Australia.
School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia.
J Med Radiat Sci. 2023 Jun;70(2):199-205. doi: 10.1002/jmrs.669. Epub 2023 Mar 8.
We present the first case in the literature of a 78-year-old woman with recurrent cardiac sarcoma adjacent to a bioprosthetic mitral valve treated with magnetic resonance linear accelerator (MR-Linac) guided adaptive stereotactic ablative body radiotherapy (SABR). The patient was treated using a 1.5 T Unity MR-Linac system (Elekta AB, Stockholm, Sweden). The mean gross tumour volume (GTV) size was 17.9 cm (range 16.6-18.9 cm ) based on daily contours and the mean dose received by the GTV was 41.4 Gy (range 40.9-41.6 Gy) in five fractions. All fractions were completed as planned and the patient tolerated the treatment well with no acute toxicity reported. Follow-up appointments at 2 and 5 months after the last treatment showed stable disease and good symptomatic relief. Results of transthoracic echocardiogram after radiotherapy showed that the mitral valve prosthesis was normally seated with regular functionality. This study provides evidence that MR-Linac guided adaptive SABR is a safe and viable option for the treatment of recurrent cardiac sarcoma with mitral valve bioprosthesis.
我们报告了首例文献中的病例，一名 78 岁女性患有心脏肉瘤，该肉瘤紧邻二尖瓣生物瓣，采用磁共振直线加速器（MR-Linac）引导的自适应立体定向消融体放射治疗（SABR）进行治疗。患者采用 1.5TUnityMR-Linac 系统（ElektaAB，斯德哥尔摩，瑞典）进行治疗。基于每日轮廓，平均肿瘤总体积（GTV）大小为 17.9cm（范围 16.6-18.9cm），GTV 接受的平均剂量为 41.4Gy（范围 40.9-41.6Gy），共 5 个分次。所有分次均按计划完成，患者耐受良好，无急性毒性反应。最后一次治疗后 2 个月和 5 个月的随访显示疾病稳定，症状缓解良好。放射治疗后的经胸超声心动图结果显示二尖瓣生物瓣假体位置正常，功能正常。这项研究为 MR-Linac 引导的自适应 SABR 治疗伴有二尖瓣生物瓣的复发性心脏肉瘤提供了安全有效的治疗选择。
