Calypso系统在肝脏立体定向放疗中的临床作用观察

Clinical observation of Calypso system in liver SBRT

目的 探讨基于Calypso系统的电磁导航在门控肝立体定向放射治疗(SBRT)肿瘤实时追踪中的临床作用和价值。方法 选择2019年4月至2020年7月江苏省肿瘤医院,在Calypso电磁转发器的引导下,进行肝脏SBRT的4例患者为研究对象。所有患者在电磁运动监测系统基础上配合呼气末屏气的呼吸门控治疗,分别记录每次治疗时间。评估放疗急性反应及远期不良反应,并在后续随访中评估疗效。采用调查问卷评估患者的治疗积极性及各个方面的主观结果。结果 所有患者转发器植入过程顺利,计划靶区是通过各个方向将临床靶区扩大5 mm边缘而形成。3例患者在治疗中观察到Ⅰ度骨髓抑制,无患者出现放射性肝损伤或其他不良反应。4例患者疗效评价均为疾病稳定。后续调查问卷显示所有患者在治疗过程中非常积极,自由呼吸患者反映舒适性更高。结论 基于Calypso电磁运动监测系统为追踪肝脏肿瘤靶区提供了一种实时直接有效的方法,值得临床推广应用。

Objective To investigate the clinical value of the electromagnetic navigation based on Calypso system in the real-time tracking of gated liver stereotactic body radiotherapy(SBRT)tumors.MethodsBetween April 2019 and July 2020,4 patients with liver cancer who were treated with liver SBRT under the guidance of electromagnetic beacons implanted.All the patients were treated with respiratory gating based on electromagnetic navigation.And clinical evaluation of the acute reaction and long-term side effects of radiotherapy were performed.The questionnaire was used to evaluate patients'enthusiasm for treatment and subjective results in various aspects.Results The beacons implantation process for all patients went smoothly.And the planning target volume was formed by expanding the clinical target volume edge by 5 mm in all directions.First-degree of bone marrow suppression was found in 3 patients during treatment.No patients had radiation liver injury or other adverse reactions.And the efficacy evaluation of 4 patients were all SD.The follow-up questionnaire showed that all patients hold positive attitude on the treatment.And the free-breathing patients reported higher comfort.Conclusions Electromagnetic navigation based on Calypso system provides a real-time and direct method for tracking liver tumor targets,which is worthy of clinical application.