AI 中文总结
本研究通过对使用1.5T MR-linac的国际机构用户开展调查，明确了心脏MRgRT治疗的模式、可行性及早期结局，为制定相关治疗建议提供真实世界依据。
AI 中文摘要
背景：心脏肿瘤较为罕见，通常采用外科切除术治疗，该治疗方式复杂、有创且存在操作风险。MRI引导放疗（MRgRT）通过软组织成像和自适应放疗技术，可无创地实现适形剂量递送。目的：为评估MRgRT在心脏肿瘤中的应用，我们对使用1.5T MR-linac的用户开展了护理模式分析。材料与方法：向使用1.5T MR-linac治疗心脏肿瘤患者的用户发放调查问卷，问卷包含30个问题，涉及患者队列、成像、治疗计划/模拟、放疗治疗及治疗结局。结果：来自6个国际机构的用户完成了调查，报告了2021-2024年间的12例心脏MRgRT治疗。患者中位年龄[范围]为59岁[16-81岁]，50%的病例涉及原发肿瘤治疗。处方剂量范围为30-60 Gy，其中30 Gy处方占比最高（59%）。75%的病例采用5次分割方式递送治疗，每次分割剂量为6-8 Gy。每日采集T1和T2加权MRI图像，92%的病例采用电影成像进行呼吸运动监测。1例病例采用MR-linac上供应商提供的新型门控解决方案进行分次内运动管理。50%的病例报告了治疗结局。除1例外，所有病例均通过MRgRT实现局部控制，且无严重不良事件（≥3级）。结论：本研究提供了可行性及早期结局的真实世界见解，以助力心脏MRgRT治疗建议和方案协调的制定。
英文摘要
Background: Cardiac tumours are rare and treated by surgical resections, which are complex, invasive and carry procedural risks. MRI-guided radiotherapy (MRgRT) noninvasively facilitates conformal dose deliveries using soft-tissue imaging and adaptive radiotherapy techniques. Aim: To assess the application of MRgRT for cardiac tumours, we conducted a patterns-of-care analysis with users of the 1.5T MR-linac. Materials & methods: A survey was distributed to users of the 1.5T MR-linac that treated patients with cardiac tumours. The survey included 30 questions concerning the patient cohort, imaging, treatment planning/simulation, radiotherapy treatment and treatment outcome. Results: Users from six international institutes completed the survey reporting twelve cardiac MRgRT treatments between 2021-2024. The median age[range] of the patients was 59[16-81] years with 50% of the cases concerning the treatment of primary tumours. The prescribed dose ranged between 30-60 Gy, with 30 Gy being prescribed the most (59%). In 75% of the cases, the treatment plans were delivered in five fractions with 6-8 Gy per fraction. Daily images were acquired with T1- and T2-weighted MRI and respiratory motion monitoring was performed in 92% of the cases using cine imaging. A single case was treated with intrafraction motion management using a novel vendor-provided gating solution on the MR-linac. Treatment outcomes were reported for 50% of the cases. All, but one case, attained local control using MRgRT without serious adverse events (grade$\geq$3). Conclusion: This study provides real-world insights into the feasibility and early outcomes to aid the development of cardiac MRgRT treatment recommendations and protocol harmonization.
