A simple procedure to plan, verify and implement craniospinal irradiation（CSI） with patients supine is presented. Treatment is conducted with a single posterior spinal field abutting two lateral cranial fields. The ...A simple procedure to plan, verify and implement craniospinal irradiation（CSI） with patients supine is presented. Treatment is conducted with a single posterior spinal field abutting two lateral cranial fields. The opposed lateral fields are half-blocked and the inferior line is perpendicular. The posterior field uses some fixed field parameters so that the cephalad edge of the posterior field is coplanar with the caudal edges of the lateral fields and it is independent of the height of the couch. A steel-shot ball is used to measure the size of overlap or gap at the junction using portal images of an electron portal image device or portal films. The results of analyzing the portal images show that the errors of the junction are within ± 1 mm. The dose-volume histograms （DVHs）show that there are not unbearable hot or cold spots in the clinic target volumes （CTVs）. Supine craniospinal treatment is a reliable and convenient alternative to treatment in the prone position and avoids the technical difficulties of the latter. The use of fixed field geometry greatly facilitates treatment planning and effectively reduces the amount of time of setup, verification and treatment.展开更多
Non-small cell lung cancer(NSCLC) ranks as the leading cause of cancer-related death in the world. Brain metastasis(BM) is a common complication of NSCLC, with 25%–40% of patients developing BM during the course of t...Non-small cell lung cancer(NSCLC) ranks as the leading cause of cancer-related death in the world. Brain metastasis(BM) is a common complication of NSCLC, with 25%–40% of patients developing BM during the course of the disease. A significant strategy of local disease control in the central nervous system is radiation therapy. With the development of precision medicine,the concept of treating lung cancer BM has gradually changed. In this case, we performed a surgical procedure to obtain enough tumor tissue for the detection of the target gene and other related experiments after the patient was informed. Finally, we found that the patient had both hepatocyte growth factor receptor(MET) gene amplification and kinesin light chain 1-anaplastic lymphoma kinase fusion(KLC1-ALK) through next-generation sequencing and showed sensitivity to the targeted therapy of crizotinib. The patient exhibited good response. Our case was successful and underwent targeted therapy with the guidance of precise diagnosis.展开更多
文摘A simple procedure to plan, verify and implement craniospinal irradiation（CSI） with patients supine is presented. Treatment is conducted with a single posterior spinal field abutting two lateral cranial fields. The opposed lateral fields are half-blocked and the inferior line is perpendicular. The posterior field uses some fixed field parameters so that the cephalad edge of the posterior field is coplanar with the caudal edges of the lateral fields and it is independent of the height of the couch. A steel-shot ball is used to measure the size of overlap or gap at the junction using portal images of an electron portal image device or portal films. The results of analyzing the portal images show that the errors of the junction are within ± 1 mm. The dose-volume histograms （DVHs）show that there are not unbearable hot or cold spots in the clinic target volumes （CTVs）. Supine craniospinal treatment is a reliable and convenient alternative to treatment in the prone position and avoids the technical difficulties of the latter. The use of fixed field geometry greatly facilitates treatment planning and effectively reduces the amount of time of setup, verification and treatment.
基金supported by the National Natural Science Foundation of China(Grant No.81472473)National Science and Technology Support Program of China(Grant No.2015BAI12B15 and 2015BAI12B12)+1 种基金Project of Science and Technology of Tianjin(Grant No.13ZCZCSY20300)Key Project of Health Industry of Tianjin(Grant No.16KG126)
文摘Non-small cell lung cancer(NSCLC) ranks as the leading cause of cancer-related death in the world. Brain metastasis(BM) is a common complication of NSCLC, with 25%–40% of patients developing BM during the course of the disease. A significant strategy of local disease control in the central nervous system is radiation therapy. With the development of precision medicine,the concept of treating lung cancer BM has gradually changed. In this case, we performed a surgical procedure to obtain enough tumor tissue for the detection of the target gene and other related experiments after the patient was informed. Finally, we found that the patient had both hepatocyte growth factor receptor(MET) gene amplification and kinesin light chain 1-anaplastic lymphoma kinase fusion(KLC1-ALK) through next-generation sequencing and showed sensitivity to the targeted therapy of crizotinib. The patient exhibited good response. Our case was successful and underwent targeted therapy with the guidance of precise diagnosis.
