{"title":"Cardiac dosage comparison among whole breast irradiation and partial breast irradiation techniques","authors":"S. Chiang, Han-Ping Hsueh, Wen-Shan Liu","doi":"10.21037/tro-21-27","DOIUrl":"https://doi.org/10.21037/tro-21-27","url":null,"abstract":"","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49517592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Can patients with recurrent high-risk prostate cancer after external beam radiotherapy (EBRT) be salvaged by low dose rate (LDR) brachytherapy: case report describing technique and application","authors":"K. Okamoto","doi":"10.21037/tro-21-12","DOIUrl":"https://doi.org/10.21037/tro-21-12","url":null,"abstract":"","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45215663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
W. Chang, Yin-Hsun Feng, Zhih-Cherng Chen, Yen-Wen Wu
{"title":"Narrative review—cardiovascular evaluation before radiotherapy for patients with breast cancer and other malignancies","authors":"W. Chang, Yin-Hsun Feng, Zhih-Cherng Chen, Yen-Wen Wu","doi":"10.21037/tro-21-21","DOIUrl":"https://doi.org/10.21037/tro-21-21","url":null,"abstract":"","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47604244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Su, Tzu-Yin Tang, Chi-Jung Li, Yu‐Chuen Huang, Yu-Jen Chen
Background: Colorectal cancer (CRC) with high level of microsatellite instability (MSI-H) is associated with improved survival. Histopathological assessment of prominent infiltration of lymphocytes in tumor microenvironment (TME), including intratumoral lymphocytic response (ILR) and peritumoral lymphocytic response (PLR), was utilized to predict MSI-H. However, the direct pathological evidence of lymphocytic response predicting survival of rectal cancer is lacking due to the predominant neoadjuvant concurrent chemoradiotherapy (CCRT) treatment. This study aims to identify whether the phenotype of PLR and ILR is associated with the clinical outcome of locally-advanced rectal cancer receiving definitive surgery followed by adjuvant CCRT. Methods: From 2005 to 2018, among the 121 patients enrolled from MacKay Memorial Hospital, 55 specimen was assessable for lymphocytic response. ILR and PLR were assessed according to the cancer reporting protocol released by the College of American Pathologists (CAP). Based on positive or negative ILR/PLR, we categorized each patient as one of the four groups: ILR+/PLR+, ILR+/PLR−, ILR−/PLR+, or ILR−/PLR−. Results: ILR−/PLR− was significantly associated with poorer overall survival, compared to either positive lymphocytic response of ILR or PLR. Multivariate analysis revealed ILR−/PLR− as a significant risk factor for overall survival after adjusting with clinical characteristics. Conclusions: Lymphocytic response in tumor microenvironment (TME) can be a predictor for poor survival outcome and a potential indicator for immunotherapy.
{"title":"Intratumoral and peritumoral lymphocytic responses correlate with survival in rectal cancer","authors":"C. Su, Tzu-Yin Tang, Chi-Jung Li, Yu‐Chuen Huang, Yu-Jen Chen","doi":"10.21037/tro-21-13","DOIUrl":"https://doi.org/10.21037/tro-21-13","url":null,"abstract":"Background: Colorectal cancer (CRC) with high level of microsatellite instability (MSI-H) is associated with improved survival. Histopathological assessment of prominent infiltration of lymphocytes in tumor microenvironment (TME), including intratumoral lymphocytic response (ILR) and peritumoral lymphocytic response (PLR), was utilized to predict MSI-H. However, the direct pathological evidence of lymphocytic response predicting survival of rectal cancer is lacking due to the predominant neoadjuvant concurrent chemoradiotherapy (CCRT) treatment. This study aims to identify whether the phenotype of PLR and ILR is associated with the clinical outcome of locally-advanced rectal cancer receiving definitive surgery followed by adjuvant CCRT. Methods: From 2005 to 2018, among the 121 patients enrolled from MacKay Memorial Hospital, 55 specimen was assessable for lymphocytic response. ILR and PLR were assessed according to the cancer reporting protocol released by the College of American Pathologists (CAP). Based on positive or negative ILR/PLR, we categorized each patient as one of the four groups: ILR+/PLR+, ILR+/PLR−, ILR−/PLR+, or ILR−/PLR−. Results: ILR−/PLR− was significantly associated with poorer overall survival, compared to either positive lymphocytic response of ILR or PLR. Multivariate analysis revealed ILR−/PLR− as a significant risk factor for overall survival after adjusting with clinical characteristics. Conclusions: Lymphocytic response in tumor microenvironment (TME) can be a predictor for poor survival outcome and a potential indicator for immunotherapy.","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46471819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Chi, Jen-Hong Wu, S. Shaw, Ching-Jung Wu, Liang-Kuang Chen, H. Hsu, K. Chi
{"title":"Marked local and distant response of heavily treated breast cancer with cardiac metastases treated by combined low dose radiotherapy, low dose immunotherapy and hyperthermia: a case report","authors":"M. Chi, Jen-Hong Wu, S. Shaw, Ching-Jung Wu, Liang-Kuang Chen, H. Hsu, K. Chi","doi":"10.21037/tro-21-16","DOIUrl":"https://doi.org/10.21037/tro-21-16","url":null,"abstract":"","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44409593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiaoning Ding, J. Younkin, Jiajian Shen, M. Bues, Wei Liu
{"title":"A critical review of the practices of proton daily quality assurance programs","authors":"Xiaoning Ding, J. Younkin, Jiajian Shen, M. Bues, Wei Liu","doi":"10.21037/tro-21-11","DOIUrl":"https://doi.org/10.21037/tro-21-11","url":null,"abstract":"","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45038138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cheng-Yen Lee, Y. Hsu, Ming-Yang Lee, Chuan-Yin Fang, Chien-Chin Chen, Hsuan-Ying Huang, Yuhong Liu
Epithelioid inflammatory myofibroblastic sarcoma (EIMS) is a highly aggressive variant of inflammatory myofibroblastic tumor (IMT). It is characterized immunohistologically by anaplastic lymphoma kinase (ALK) overexpression and genetic rearrangements in selected cases. The clinical significance of ALK rearrangement on radiotherapy was never reported in EIMS. Here we report a case of locally advanced rectal EIMS. In 2017, a 62-year-old woman was offered laparoscopic abdominoperineal resection for locally advanced EIMS of the rectum. Initial presentation was hematochezia and unintentional body weight loss. The resected tumor was positive for Ran-binding protein (RANBP2)-ALK fusion oncogene. Adjuvant radiotherapy was arranged for microscopic residual disease. Rapid intra-abdominal dissemination and local failure were identified shortly after the assigned treatments. She succumbed to the disease 134 days after diagnosis. In the era of precision oncology, the clinical significance of RANBP2-ALK recombination should be recognized. As treatment options are limited at time of treatment failure, upfront ALK inhibitor may be
{"title":"Clinical significance of recombinant RANBP2-ALK oncogene to radiotherapy in a case of locally advanced rectal epithelioid inflammatory myofibroblastic sarcoma: case report and review of literature","authors":"Cheng-Yen Lee, Y. Hsu, Ming-Yang Lee, Chuan-Yin Fang, Chien-Chin Chen, Hsuan-Ying Huang, Yuhong Liu","doi":"10.21037/tro.2020.04.01","DOIUrl":"https://doi.org/10.21037/tro.2020.04.01","url":null,"abstract":"Epithelioid inflammatory myofibroblastic sarcoma (EIMS) is a highly aggressive variant of inflammatory myofibroblastic tumor (IMT). It is characterized immunohistologically by anaplastic lymphoma kinase (ALK) overexpression and genetic rearrangements in selected cases. The clinical significance of ALK rearrangement on radiotherapy was never reported in EIMS. Here we report a case of locally advanced rectal EIMS. In 2017, a 62-year-old woman was offered laparoscopic abdominoperineal resection for locally advanced EIMS of the rectum. Initial presentation was hematochezia and unintentional body weight loss. The resected tumor was positive for Ran-binding protein (RANBP2)-ALK fusion oncogene. Adjuvant radiotherapy was arranged for microscopic residual disease. Rapid intra-abdominal dissemination and local failure were identified shortly after the assigned treatments. She succumbed to the disease 134 days after diagnosis. In the era of precision oncology, the clinical significance of RANBP2-ALK recombination should be recognized. As treatment options are limited at time of treatment failure, upfront ALK inhibitor may be","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46030956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The long-term outcome for early stage tongue cancer is generally good, however patients who suffered from local recurrence experienced a worse outcome than those who had not. The purpose of this study was to analyze long-term outcome for early stage tongue cancer patients treated by surgery alone for potential factors in predicting any subsequent relapse. Methods: The inclusion criteria for this retrospective study involved previously untreated, biopsy-proven squamous cell carcinoma (SCC) of the tongue, clinical stage T1-2N0M0 and patients who had received surgery alone. From February 2007 to January 2015, the chart records and images of 199 eligible patients were reviewed. Results: After a medial follow-up period of 89 months, we discovered 53 recurrences and 34 deaths. The 5-year overall survival (OS) and locoregional failure-free survival (LRFFS) rates were 83.9% and 72.4%, respectively. Univariate and multivariate analyses revealed that a poorly differentiated histology, depth of invasion (DOI) >5 mm, and perineural invasion (PNI) affected both OS and LRFFS. Patients with an absence of any risk factors (poorly differentiated histology, invasion depth over 5 mm, and PNI) experienced significantly better OS (5-year rates, 92.0% vs. 72.7%, P=0.0001) and LRFFS (5-year rates, 76.8% vs. 66.6 %, P=0.0382) than those with at least one of the risk factors. Conclusions: An overall relapse rate of 26.6% was observed for patients with early tongue cancer treated by surgery alone. Patients with risk factors (poorly differentiated histology, DOI >5 mm, and PNI) should be considered for postoperative adjuvant therapy in future trials. 8
背景:早期舌癌的长期预后通常是良好的，然而局部复发的患者的预后比没有复发的患者差。本研究的目的是分析早期舌癌患者单独手术治疗的长期预后，以预测任何后续复发的潜在因素。方法:本回顾性研究的纳入标准包括先前未经治疗、活检证实的舌鳞状细胞癌(SCC)、临床分期T1-2N0M0和单独接受手术的患者。回顾2007年2月至2015年1月199例符合条件的患者的病历记录和影像。结果:经过89个月的随访，发现53例复发，34例死亡。5年总生存率(OS)和局部无故障生存率(LRFFS)分别为83.9%和72.4%。单因素和多因素分析显示，低分化组织学、浸润深度(DOI)约0.5 mm和神经周围浸润(PNI)对OS和LRFFS都有影响。没有任何危险因素(组织学差分化、浸润深度大于5mm、PNI)的患者的OS(5年生存率，92.0% vs. 72.7%， P=0.0001)和LRFFS(5年生存率，76.8% vs. 66.6%， P=0.0382)明显优于至少有一种危险因素的患者。结论:单纯手术治疗的早期舌癌患者复发率为26.6%。在未来的试验中，有危险因素(低分化组织学、DOI bbb50 mm和PNI)的患者应考虑术后辅助治疗。8
{"title":"Survival outcome and prognostic factor analyses in early tongue cancer patients treated with surgery alone","authors":"Hao-shen Cheng, Shih-An Liu, Jin-Ching Lin","doi":"10.21037/TRO.2020.01.02","DOIUrl":"https://doi.org/10.21037/TRO.2020.01.02","url":null,"abstract":"Background: The long-term outcome for early stage tongue cancer is generally good, however patients who suffered from local recurrence experienced a worse outcome than those who had not. The purpose of this study was to analyze long-term outcome for early stage tongue cancer patients treated by surgery alone for potential factors in predicting any subsequent relapse. Methods: The inclusion criteria for this retrospective study involved previously untreated, biopsy-proven squamous cell carcinoma (SCC) of the tongue, clinical stage T1-2N0M0 and patients who had received surgery alone. From February 2007 to January 2015, the chart records and images of 199 eligible patients were reviewed. Results: After a medial follow-up period of 89 months, we discovered 53 recurrences and 34 deaths. The 5-year overall survival (OS) and locoregional failure-free survival (LRFFS) rates were 83.9% and 72.4%, respectively. Univariate and multivariate analyses revealed that a poorly differentiated histology, depth of invasion (DOI) >5 mm, and perineural invasion (PNI) affected both OS and LRFFS. Patients with an absence of any risk factors (poorly differentiated histology, invasion depth over 5 mm, and PNI) experienced significantly better OS (5-year rates, 92.0% vs. 72.7%, P=0.0001) and LRFFS (5-year rates, 76.8% vs. 66.6 %, P=0.0382) than those with at least one of the risk factors. Conclusions: An overall relapse rate of 26.6% was observed for patients with early tongue cancer treated by surgery alone. Patients with risk factors (poorly differentiated histology, DOI >5 mm, and PNI) should be considered for postoperative adjuvant therapy in future trials. 8","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/TRO.2020.01.02","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47031642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-18DOI: 10.21037/tro-17-tastro-16
Yen-Ting Liu, S. Kuo, Ting‐Chen Chang, Chao-yuan Huang
Sacral insufficiency fracture (SIF) is a common cause of back pain in the elderly. However, SIF is still under-diagnosis. We presented a patient with endometrial cancer who complained of low back pain after adjuvant radiotherapy. Finally, SIF was detected by magnetic resonance imaging (MRI). This 66-year-old woman was diagnosed with endometrioid adenocarcinoma, stage Ia, grade 3. She received staging surgery (total abdominal hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic lymph nodes dissection, omental biopsy and peritoneal washing cytology) followed by adjuvant radiotherapy with the dose of 50.4 Gy in 28 fractions to pelvic lymphatics and vaginal stump (from November 2014 to December 2014). After completion of radiotherapy for 6 months, she complained of diffuse low back pain, but denied any trauma history. The results of physical examination for pelvic and rectal area were normal. The abdomenpelvis computer tomography revealed no significant finding. The whole body bone scans disclosed the suspect bone metastases at left sacroiliac joint (SI joint). Considering the osteoporosis-associated fracture is common present in elderly women, we perform the MRI of SI joint to differentiate whether these lesions are benign process or malignancy. The result of MRI confirmed the diagnosis of radiation-associated SIF which is characterized by the signs of marrow edema (more obvious by STIR, Short T1 Inversion Recovery, MRI images). She received supportive care and had back pain subsided during regular follow-up. With the accurate diagnosis of SIF but not bony metastasis, this patient had subsequent favorable clinical course and outcome with resolution of symptoms by conservative treatment.
{"title":"Radiation-induced sacral insufficiency fracture in endometrial cancer patient after adjuvant radiotherapy: a case report","authors":"Yen-Ting Liu, S. Kuo, Ting‐Chen Chang, Chao-yuan Huang","doi":"10.21037/tro-17-tastro-16","DOIUrl":"https://doi.org/10.21037/tro-17-tastro-16","url":null,"abstract":"Sacral insufficiency fracture (SIF) is a common cause of back pain in the elderly. However, SIF is still under-diagnosis. We presented a patient with endometrial cancer who complained of low back pain after adjuvant radiotherapy. Finally, SIF was detected by magnetic resonance imaging (MRI). This 66-year-old woman was diagnosed with endometrioid adenocarcinoma, stage Ia, grade 3. She received staging surgery (total abdominal hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic lymph nodes dissection, omental biopsy and peritoneal washing cytology) followed by adjuvant radiotherapy with the dose of 50.4 Gy in 28 fractions to pelvic lymphatics and vaginal stump (from November 2014 to December 2014). After completion of radiotherapy for 6 months, she complained of diffuse low back pain, but denied any trauma history. The results of physical examination for pelvic and rectal area were normal. The abdomenpelvis computer tomography revealed no significant finding. The whole body bone scans disclosed the suspect bone metastases at left sacroiliac joint (SI joint). Considering the osteoporosis-associated fracture is common present in elderly women, we perform the MRI of SI joint to differentiate whether these lesions are benign process or malignancy. The result of MRI confirmed the diagnosis of radiation-associated SIF which is characterized by the signs of marrow edema (more obvious by STIR, Short T1 Inversion Recovery, MRI images). She received supportive care and had back pain subsided during regular follow-up. With the accurate diagnosis of SIF but not bony metastasis, this patient had subsequent favorable clinical course and outcome with resolution of symptoms by conservative treatment.","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/tro-17-tastro-16","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42677004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael D Chuong, D. Alvarez, T. Romaguera, K. Mittauer, Sonia Adamson, Alonso N. Gutierrez, G. Luciani, Hayden Guerrero, Antonio Ucar
: Several randomized trials have demonstrated that stereotactic body radiation therapy (SBRT) can significantly improve long-term clinical outcomes for patients with oligometastatic (OM) cancer, commonly defined as 1–5 metastatic lesions. Some lesions, especially those in the abdomen and pelvis, may not be appropriate candidates for receiving ablative dose if daily on-board computed tomography (CT) is used because of limited target lesion and normal anatomy visualization. Magnetic resonance imaging (MRI) inherently provides superior soft tissue delineation as compared to CT and only recently have MR-guided linear accelerators (LINACs) become commercially available. MR-LINACs can also perform daily online adaptive replanning based on the current day’s anatomy, further positioning this novel technology as a preferred means to safely deliver ablative dose, even to targets in anatomically challenging locations. Here we present the case of a 49-year-old man with bladder cancer who underwent cystectomy and developed metachronous disease in 2 mesenteric lymph nodes for which he received MR-guided SBRT with daily online adaptive replanning to a prescription dose of 50 Gy in 5 fractions. He achieved a significant radiographic response and did not experience significant treatment-related toxicity. We discuss unique advantages of MR guidance and novel applications, especially in the context of OM disease.
{"title":"Case report of ablative magnetic resonance-guided stereotactic body radiation therapy for oligometastatic mesenteric lymph nodes from bladder cancer","authors":"Michael D Chuong, D. Alvarez, T. Romaguera, K. Mittauer, Sonia Adamson, Alonso N. Gutierrez, G. Luciani, Hayden Guerrero, Antonio Ucar","doi":"10.21037/tro-20-37","DOIUrl":"https://doi.org/10.21037/tro-20-37","url":null,"abstract":": Several randomized trials have demonstrated that stereotactic body radiation therapy (SBRT) can significantly improve long-term clinical outcomes for patients with oligometastatic (OM) cancer, commonly defined as 1–5 metastatic lesions. Some lesions, especially those in the abdomen and pelvis, may not be appropriate candidates for receiving ablative dose if daily on-board computed tomography (CT) is used because of limited target lesion and normal anatomy visualization. Magnetic resonance imaging (MRI) inherently provides superior soft tissue delineation as compared to CT and only recently have MR-guided linear accelerators (LINACs) become commercially available. MR-LINACs can also perform daily online adaptive replanning based on the current day’s anatomy, further positioning this novel technology as a preferred means to safely deliver ablative dose, even to targets in anatomically challenging locations. Here we present the case of a 49-year-old man with bladder cancer who underwent cystectomy and developed metachronous disease in 2 mesenteric lymph nodes for which he received MR-guided SBRT with daily online adaptive replanning to a prescription dose of 50 Gy in 5 fractions. He achieved a significant radiographic response and did not experience significant treatment-related toxicity. We discuss unique advantages of MR guidance and novel applications, especially in the context of OM disease.","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43526851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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