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中华结直肠疾病电子杂志 ›› 2023, Vol. 12 ›› Issue (06) : 519 -523. doi: 10.3877/cma.j.issn.2095-3224.2023.06.014

经验交流

磁共振加速器治疗局部晚期直肠癌的初步经验
马慧颖, 凡新苓, 覃仕瑞, 陈佳赟, 曹莹, 徐源, 金晶, 唐源()   
  1. 100021 北京,国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院放疗科
    100021 北京,国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院放疗科;518116 深圳,国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院深圳医院放疗科
  • 收稿日期:2023-10-19 出版日期:2023-12-25
  • 通信作者: 唐源
  • 基金资助:
    国家自然科学基金面上项目(No. 82073352)

Magnetic resonance linac for locally advanced rectal cancer: a preliminary experience

Huiying Ma, Xinling Fan, Shirui Tan, Jiayun Chen, Ying Cao, Yuan Xu, Jing Jin, Yuan Tang()   

  1. Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
    Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China
  • Received:2023-10-19 Published:2023-12-25
  • Corresponding author: Yuan Tang
引用本文:

马慧颖, 凡新苓, 覃仕瑞, 陈佳赟, 曹莹, 徐源, 金晶, 唐源. 磁共振加速器治疗局部晚期直肠癌的初步经验[J/OL]. 中华结直肠疾病电子杂志, 2023, 12(06): 519-523.

Huiying Ma, Xinling Fan, Shirui Tan, Jiayun Chen, Ying Cao, Yuan Xu, Jing Jin, Yuan Tang. Magnetic resonance linac for locally advanced rectal cancer: a preliminary experience[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 519-523.

磁共振加速器作为一种新型的放射治疗设备,应用于直肠癌的经验较少报道。本文介绍了磁共振加速器治疗直肠癌的步骤,并报告了使用该步骤治疗6例局部晚期直肠癌的初步治疗结果。6例直肠肿瘤均退缩,其中2例(2/6)可达肿瘤完全消退,所有患者放疗期间未出现3度以上毒副反应。每次放疗实施前,MR图像显示解剖、靶区清晰,可顺利实现在线自适应放疗和实时跟踪放疗。磁共振加速器在直肠癌放疗方面具有良好的应用前景。

As an emerging radiation therapy modality, experience with magnetic resonance linac (MR-Linac) for rectal cancer is rarely reported. This article introduces a procedure for the treatment of rectal cancer with MR-Linac and reports the preliminary results of the treatment of 6 cases of locally advanced rectal cancer using this procedure. All of the rectal tumors regressed, with 2 cases (2/6) achieving complete tumor regression, and no≥G3 acute toxicities occurred during radiation therapy. Before the implementation of each radiotherapy, MR image shows the anatomy and target volume clearly, which can successfully realize online adaptive radiotherapy and real-time tracking radiotherapy. MR-linac has a good prospect in the radiotherapy of rectal cancer.

表1 MR-Linac治疗6例局部晚期直肠癌患者的临床特点
表2 MR-Linac治疗6例局部晚期直肠癌患者的治疗情况
图1 MR-Linac治疗局部晚期直肠癌的关键流程
图2 MR-Linac治疗局部晚期直肠癌的计划图像(红色轮廓为GTV,绿色轮廓为PTV,剂量覆盖好,适形度高)
图3 MR-Linac治疗局部晚期直肠癌期间实时MR监控图像(绿色轮廓为PTV,治疗期PTV对实际治疗区域覆盖满意,对正常器官保护好)
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