Volumetric-modulated arc stereotactic radiotherapy for intramedullary cervical spinal cord metastases: Report of two cases

Q4 Health Professions
Y. Mori, Toshie Mori, K. Adachi, S. Abe, Y. Oshima, A. Takeuchi, Makoto Ito
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引用次数: 0

Abstract

The treatment results of intensity-modulated stereotactic radiotherapy (IMSRT) by volumetric-modulated arc therapy (VMAT) for intramedullary cervical spinal cord metastases (IMCSCM) in two cases were presented. Case 1: A 76year-old woman showed left-sided motor weakness and left arm pain and dysesthesia due to IMCSCM at C [cervical] 6-7 (located a little to the left laterally) with multiple small brain metastases from thyroid carcinoma. Multiple brain metastases were successfully treated by stereotactic radiosurgery (SRS). In addition, IMCSCM was treated by IM-SRT. Case 2: A 48year-old man presented with asymptomatic IMCSCM at C2 (located a little to the right laterally) after conventional whole brain radiotherapy (WBRT) and multiple sessions of SRS/SRT for multiple brain metastases from lung adenocarcinoma. IMCSCM was treated by IM-SRT. In both cases 39 Gy in 13 fractions (without PTV [planning target volume] margin, D95%=95% dose) was delivered to the IMCSCM (0.3 ml and 0.5 ml in volume respectively) by coplanar 2-full circular arc VMAT. The maximum dose to the tumor was 46.3 Gy in case 1 and 47.1 Gy in case 2. IMCSCM in both cases shrank markedly without adverse effects during the follow-up period of 32 months and 8 months respectively. The symptoms of the extremities in case 1 were subsided completely until the patient’s death at 34 months after SRT from lung metastasis. In case 1 IMCSCM had been thought to be a relatively radioresistant thyroid carcinoma metastasis. In case 2 IMCSCM was near the field of the prior WBRT. However, both tumors were successfully treated without adverse effects by VMAT IM-SRT.
体积调节电弧立体定向放疗治疗髓内颈脊髓转移:附2例报告
本文报道了2例髓内颈脊髓转移瘤(IMCSCM)的调强立体定向放射治疗(IMSRT)和体积调节电弧治疗(VMAT)的治疗结果。病例1:一名76岁的女性,由于C[颈椎]6-7(位于偏左外侧)的IMCSCM,表现为左侧运动无力,左臂疼痛和感觉不良,并伴有甲状腺癌多发小脑转移。立体定向放射外科(SRS)成功治疗多发性脑转移瘤。此外,imm - srt治疗IMCSCM。病例2:一名48岁男性,在常规全脑放疗(WBRT)和多次SRS/SRT治疗肺腺癌多发脑转移后,在C2(位于稍偏右外侧)出现无症状IMCSCM。imm - srt治疗IMCSCM。在这两种情况下,39 Gy分13份(无PTV[计划目标体积]边界,D95%=95%剂量)通过共面2-全圆弧VMAT输送到IMCSCM(分别为0.3 ml和0.5 ml体积)。病例1和病例2的最大肿瘤剂量分别为46.3 Gy和47.1 Gy。随访时间分别为32个月和8个月,两例患者IMCSCM均明显缩小,无不良反应。病例1的四肢症状完全消退,直到患者在SRT后34个月因肺转移而死亡。在病例1中,IMCSCM被认为是一种相对放射抵抗的甲状腺癌转移。在病例2中,IMCSCM靠近先前WBRT的场。然而,VMAT IM-SRT成功治疗了两种肿瘤,无不良反应。
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来源期刊
Iranian Journal of Radiation Research
Iranian Journal of Radiation Research RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
0.67
自引率
0.00%
发文量
0
审稿时长
>12 weeks
期刊介绍: Iranian Journal of Radiation Research (IJRR) publishes original scientific research and clinical investigations related to radiation oncology, radiation biology, and Medical and health physics. The clinical studies submitted for publication include experimental studies of combined modality treatment, especially chemoradiotherapy approaches, and relevant innovations in hyperthermia, brachytherapy, high LET irradiation, nuclear medicine, dosimetry, tumor imaging, radiation treatment planning, radiosensitizers, and radioprotectors. All manuscripts must pass stringent peer-review and only papers that are rated of high scientific quality are accepted.
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