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扇形束计算机断层扫描引导下的自适应放射治疗（FBCT-gART）治疗多发腹部促结缔组织增生性小圆细胞肿瘤：一例报告

Multiple Abdominal Desmoplastic Small Round-Cell Tumors Treated With Fan Beam Computed Tomography-Guided Adaptive Radiotherapy (FBCT-gART): A Case Report.

作者信息

Wang Haohua, Zhang Xiang, Yue Jinbo

机构信息

Radiation Oncology, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, CHN.

出版信息

Cureus. 2024 Sep 20;16(9):e69785. doi: 10.7759/cureus.69785. eCollection 2024 Sep.

DOI:10.7759/cureus.69785
PMID:39308846
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11414420/
Abstract

Desmoplastic small round cell tumor (DSRCT) is a rare and highly aggressive soft tissue tumor that predominantly affects the abdominal and pelvic regions of adolescent males. This case report presents our clinical experience of treating a 33-year-old male with multifocal peritoneal DSRCT using fan beam computed tomography-guided adaptive radiotherapy (FBCT-gART). The patient presented with abdominal pain and was diagnosed with DSRCT following imaging and biopsy. Despite initial treatment with surgery, chemotherapy, and targeted therapy, the patient experienced multifocal peritoneal recurrence. Due to the considerable mobility of the abdominal tumors and the associated risks to adjacent critical organs, the patient underwent daily online FBCT-gART. The prescribed dose regimen was 54 Gy delivered in 27 fractions at 2 Gy per fraction; however, the patient ultimately received only 25 treatments for personal reasons. This case report evaluates the technical workflow of using FBCT-gART for DSRCT and discusses its dosimetric advantages over non-adaptive radiotherapy.

摘要

促结缔组织增生性小圆细胞肿瘤（DSRCT）是一种罕见且侵袭性很强的软组织肿瘤，主要影响青少年男性的腹部和盆腔区域。本病例报告介绍了我们使用扇束计算机断层扫描引导的自适应放疗（FBCT-gART）治疗一名33岁多灶性腹膜DSRCT男性患者的临床经验。该患者因腹痛就诊，经影像学检查和活检后被诊断为DSRCT。尽管最初接受了手术、化疗和靶向治疗，但患者仍出现多灶性腹膜复发。由于腹部肿瘤活动度较大且对相邻关键器官存在相关风险，患者接受了每日在线FBCT-gART治疗。处方剂量方案为54 Gy，分27次给予，每次2 Gy；然而，由于个人原因，患者最终仅接受了25次治疗。本病例报告评估了使用FBCT-gART治疗DSRCT的技术流程，并讨论了其与非自适应放疗相比在剂量学方面的优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/815c/11414420/d21085d4f98e/cureus-0016-00000069785-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/815c/11414420/bda3343f51df/cureus-0016-00000069785-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/815c/11414420/70e395c03fb7/cureus-0016-00000069785-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/815c/11414420/8647f6d52154/cureus-0016-00000069785-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/815c/11414420/dcd7f1a1a500/cureus-0016-00000069785-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/815c/11414420/d21085d4f98e/cureus-0016-00000069785-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/815c/11414420/bda3343f51df/cureus-0016-00000069785-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/815c/11414420/70e395c03fb7/cureus-0016-00000069785-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/815c/11414420/8647f6d52154/cureus-0016-00000069785-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/815c/11414420/dcd7f1a1a500/cureus-0016-00000069785-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/815c/11414420/d21085d4f98e/cureus-0016-00000069785-i05.jpg

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本文引用的文献

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Intrafraction organ movement in adaptive MR-guided radiotherapy of abdominal lesions - dosimetric impact and how to detect its extent in advance.自适应磁共振引导放疗中腹部病变的分次内器官运动 - 剂量学影响以及如何提前检测其范围。
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胰腺癌立体定向体部放疗期间屏气间隔期危及器官的几何形状和剂量学变化：对自适应放射治疗的影响
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