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báo cáo khoa học: "Successful treatment of a T4 lung tumor with vertebral body invasion using fiducial markers in the thoracic spine for image-guided radiation therapy: A case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Successful treatment of a T4 lung tumor with vertebral body invasion using fiducial markers in the thoracic spine for image-guided radiation therapy: A case report | Jain et al. Journal of Medical Case Reports 2011 5 470 http www.jmedicalcasereports.eom content 5 1 470 JOURNALOF medical Ur Case REPORTS CASE REPORT Open Access Successful treatment of a T4 lung tumor with vertebral body invasion using fiducial markers in the thoracic spine for image-guided radiation therapy A case report Anudh K Jain1 John Handal2 and Lawrence J Solin1 Abstract Introduction Paravertebral and paraspinal tumors pose a significant challenge in radiation therapy because of the radiation sensitivity of the spinal cord and the need for maximum treatment accuracy. Implantation of fiducial markers into vertebral bodies has been described as a method of increasing the accuracy of radiation treatment for single-dose stereotactic radiosurgery for spinal and paraspinal primary tumors and metastases. However utilization of this technique has not been described for conventionally fractionated radiation therapy. This report is the first of its kind in the literature and describes successful treatment of a T4 primary lung tumor with vertebral body invasion with conventionally fractionated image-guided radiotherapy using fiducial markers implanted in the thoracic spine. Case presentation Our patient was a 47-year-old African-American man who presented to our hospital with a history of several months of increasing left arm pain chest pain dyspnea on exertion occasional dry cough and weight loss. He was found to have stage IIIA T4 N0 M0 lung cancer with vertebral body invasion. He had fiducial markers placed in the thoracic spine for image-guided radiation treatment set-up. The patient received 74 Gy radiation therapy with concurrent chemotherapy and daily matching of the fiducial markers on the treatment machine allowed for treatment of the tumor while sparing the dose to the adjacent spinal cord. With one year of clinical follow-up the patient has had regression of the tumor with only asymmetric soft-tissue thickening seen on a computed tomographic scan and grade