MR-guided stereotactic radiosurgery of an intracardiac tumoral thrombus using comprehensive motion management

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology Pub Date : 2026-05-01 Epub Date: 2026-02-04 DOI:10.1016/j.ctro.2026.101118

Shaïma El Chammah , Mickael Bendahman , Sarah Ghandour , Olivier Pisaturo , Marc Pachoud , Asteria Nikolopoulou , Mahmut Ozsahin

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Abstract

Lung cancer is often complicated by hypercoagulability, with intracardiac thrombi not an uncommon consequence. While radiotherapy can be a treatment option, effective intracardiac irradiation can be technically challenging. We present the case of a 54-year-old non-small-cell lung cancer (NSCLC) patient treated for a recurrent left atrial tumoral thrombus. The patient responded well after a first course of chemo-immuno radiotherapy. Follow up imaging showed a metabolic reactivation of the left atrial thrombus. The patient subsequently underwent an 18 Gy stereotactic radiosurgery using a 1.5 T Unity MR-Linac (Elekta AB, Sweden, Stockholm) using comprehensive motion management (CMM) to account for respiratory motion. Treatment was well tolerated. Complete metabolic response was observed 2 months after treatment. This case represents the first ever reported use of CMM on a 1.5 T MR-Linac to target an intracardiac lesion.

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核磁共振引导立体定向放射治疗心内肿瘤血栓的综合运动管理

肺癌常并发高凝，心内血栓并不少见。虽然放疗是一种治疗选择，但有效的心内照射在技术上具有挑战性。我们提出一个54岁的非小细胞肺癌（NSCLC）患者治疗复发性左心房肿瘤血栓。患者在第一疗程化疗免疫放疗后反应良好。随访影像显示左房血栓代谢再激活。患者随后接受了18 Gy立体定向放射手术，使用1.5 T Unity MR-Linac （Elekta AB，瑞典，斯德哥尔摩），使用综合运动管理（CMM）来解释呼吸运动。治疗耐受性良好。治疗2个月后观察到完全代谢缓解。该病例是首次报道在1.5 T MR-Linac上使用CMM靶向心内病变。

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