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Locally Advanced Cervical Cancer Treated with Online Adaptive Radiotherapy: A Case Report
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摘要: 在线自适应放疗技术是继调强放疗技术后的革命性进步，目前国内首个基于迭代锥形束CT(iterative cone beam computed tomography，iCBCT)的人工智能在线自适应放疗平台在北京协和医院被应用于临床治疗。本文报道北京协和医院放射治疗科首次采用基于iCBCT的在线自适应放疗技术治疗局部进展期宫颈癌患者1例，治疗后患者症状达到临床完全缓解且仅发生1级下消化道不良反应(腹泻)，未出现1级及以上的血液学、泌尿生殖系统及其他放疗相关不良反应。本文就该患者的临床诊疗过程及随访展开讨论，以期为后续大规模应用该技术提供临床借鉴。Abstract: Online adaptive radiotherapy(OART)is considered to be a revolutionary technology after intensity-modulated radiotherapy. The first Chinese OART platform based on iterative cone beam computed tomography (iCBCT)has been applied in clinical treatment in Peking Union Medical College Hospital. This article reports the workflow and efficacy of first case with cervical cancer who received radical OART. After treatment, the patient achieved clinical complete remission with only a grade 1 radiation toxicity in the lower gastrointestinal tract. This article analyzes and discusses the clinical treatment process and follow-up data of this patient, aiming to provide clinical evidence for the subsequent large-scale application of artificial intelligence-driven iCBCT-guided OART technology.作者贡献：王光宇负责数据收集、整理及论文撰写；汪之群、李文博、杨波负责放疗计划设计；张宇、孙显松负责放疗计划执行；李晶负责放疗设备的技术支持；晏俊芳、张福泉负责研究设计与论文修订。利益冲突：所有作者均声明不存在利益冲突注：本研究发表已获得患者知情同意。
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[1] Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries[J]. CA Cancer J Clin, 2021, 71: 209-249. doi: 10.3322/caac.21660 [2] Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68: 394-424. doi: 10.3322/caac.21492 [3] Naga Ch P, Gurram L, Chopra S, et al. The management of locally advanced cervical cancer[J]. Curr Opin Oncol, 2018, 30: 323-329. doi: 10.1097/CCO.0000000000000471 [4] Klopp AH, Yeung AR, Deshmukh S, et al. Patient-Reported Toxicity During Pelvic Intensity-Modulated Radiation Therapy: NRG Oncology-RTOG 1203[J]. J Clin Oncol, 2018, 36: 2538-2544. doi: 10.1200/JCO.2017.77.4273 [5] Chopra S, Gupta S, Kannan S, et al. Late Toxicity After Adjuvant Conventional Radiation Versus Image-Guided Intensity-Modulated Radiotherapy for Cervical Cancer (PARCER): A Randomized Controlled Trial[J]. J Clin Oncol, 2021, 39: 3682-3692. doi: 10.1200/JCO.20.02530 [6] Gandhi AK, Sharma DN, Rath GK, et al. Early clinical outcomes and toxicity of intensity modulated versus conventional pelvic radiation therapy for locally advanced cervix carcinoma: a prospective randomized study[J]. Int J Radiat Oncol Biol Phys, 2013, 87: 542-548. doi: 10.1016/j.ijrobp.2013.06.2059 [7] Jadon R, Pembroke CA, Hanna CL, et al. A systematic review of organ motion and image-guided strategies in external beam radiotherapy for cervical cancer[J]. Clin Oncol (R Coll Radiol), 2014, 26: 185-196. doi: 10.1016/j.clon.2013.11.031 [8] Barazzuol L, Coppes RP, van Luijk P. Prevention and treatment of radiotherapy-induced side effects[J]. Mol Oncol, 2020, 14: 1538-1554. doi: 10.1002/1878-0261.12750 [9] Hale MF. Radiation enteritis: from diagnosis to management[J]. Curr Opin Gastroenterol, 2020, 36: 208-214. doi: 10.1097/MOG.0000000000000632 [10] Åström LM, Behrens CP, Storm KS, et al. Online adaptive radiotherapy of anal cancer: Normal tissue sparing, target propagation methods, and first clinical experience[J]. Radiother Oncol, 2022, 176: 92-98. doi: 10.1016/j.radonc.2022.09.015 [11] Christiansen RL, Dysager L, Hansen CR, et al. Online adaptive radiotherapy potentially reduces toxicity for high-risk prostate cancer treatment[J]. Radiother Oncol, 2022, 167: 165-171. doi: 10.1016/j.radonc.2021.12.013 [12] Kerkhof EM, Raaymakers BW, van der Heide UA, et al. Online MRI guidance for healthy tissue sparing in patients with cervical cancer: an IMRT planning study[J]. Radiother Oncol, 2008, 88: 241-249. doi: 10.1016/j.radonc.2008.04.009 [13] Bertelsen AS, Schytte T, Møller PK, et al. First clinical experiences with a high field 1.5 T MR linac[J]. Acta Oncol, 2019, 58: 1352-1357. doi: 10.1080/0284186X.2019.1627417 [14] Alongi F, Rigo M, Figlia V, et al. 1.5 T MR-guided and daily adapted SBRT for prostate cancer: feasibility, preliminary clinical tolerability, quality of life and patient-reported outcomes during treatment[J]. Radiat Oncol, 2020, 15: 69. doi: 10.1186/s13014-020-01510-w [15] de Jong R, Visser J, van Wieringen N, et al. Feasibility of Conebeam CT-based online adaptive radiotherapy for neoadjuvant treatment of rectal cancer[J]. Radiat Oncol, 2021, 16: 136. doi: 10.1186/s13014-021-01866-7 -
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