OBJECTIVE: To investigate the recent efficacy and patient tolerability of Super Gamma Knife in the treatment of bladder cancer.
Treatment: A case of stage III bladder cancer was treated after spiral CT localization scan, treatment plan was designed by Unicom3D planning system, and SGS-I whole-body gamma-ray treatment system was used to implement the plan, wrapping around the planned target volume with 50% isodose curve, single peripheral dose of 250 cGy once a day, five times a week, total peripheral dose of 5000 cGy , total central dose of 10,000 cGy. RESULTS: The symptoms gradually improved during radiotherapy, and the lesion was smaller than before when the CT-enhanced scan was reviewed at the end of treatment, and the enhancement shadow was not obvious and the enhancement range was reduced.
Conclusion: The recent efficacy of Super Gamma Knife in treating bladder cancer is positive, significantly improving the patient’s quality of life, and it is a safe and non-invasive treatment modality.
1. case data: the patient was 66 years old, male. in August 2003, urinary frequency, urinary urgency, urinary pain, hematuria, tumor exfoliation in the urine, cystoscopy to take tissue biopsy, pathology report for bladder metastatic cell carcinoma. The tumor size was 8.29cmX4.0cmX2.11cm measured by CT image before treatment. 2. Radiotherapy method: Vacuum negative pressure bag was used for positioning, and the scan was enhanced with 5mm layer thickness by spiral CT machine, and the scanned image was transmitted to Super Gamma Knife treatment planning system with 6 targets, and 50% isodose line wrapped around more than 90% of the lesion volume. The planned target area volume (PTV) was 55.6 cc, with a single peripheral dose of 250 cGy once a day, five times a week, a total peripheral dose of 5000 cGy and a total central dose of 10,000 cGy. The bladder was filled by drinking the same amount of water as during the localized CT scan before each treatment.
3. Treatment results: The interval of urinary frequency before treatment was 15 minutes, and the pain was severe. After 6 treatments (cumulative peripheral dose of 1500 cGy), the interval of urinary frequency was extended to about 30 minutes, and the necrotic detached swelling in urine was significantly reduced during urination. After 7 treatments (cumulative peripheral dose of 1750 cGy), sexual function was restored (the patient had no sexual desire and sex life for 8 years). After 8 treatments (cumulative peripheral dose of 2000 cGy), ultrasound review showed that the lesion was smaller than before. After 10 treatments (cumulative peripheral dose of 2500 cGy), the interval of frequent urination was extended to 40 – 50 minutes, the hematuria disappeared, and only a small amount of tofu-like material was seen in the urine. After 14 treatments (accumulated peripheral dose of 3500 cGy), the interval of frequent urination exceeded 1 hour, urination could be controlled for about 20 minutes, urine was clarified, and there was no painful urination. At 20 treatments (cumulative peripheral dose of 5000 cGy), the interval of urinary frequency reached 100 minutes, urine was clarified, no urinary pain, and the lesion was reduced to 2.74cmX1.32cmX0.7cm on CT review, and the size enhancement effect was diminished. There was no significant change in leukocytes and platelets before and after treatment, and there was no obvious radiotherapy reaction.
Treatment experience: 1, conventional radiotherapy for inoperable advanced bladder cancer patients, in 4 weeks in 20 times to receive 5500 – 6000cGy radiotherapy, local control rate of 23% – 50%, 5-year survival rate of 30% – 40%, for some tumor patients to reduce the pain and prolong the survival.
2.Super Gamma Knife adopts the principle of three-dimensional focused rotating arc irradiation, which can choose any rotating arc within 360 degrees, which can make the dose field conformal to the lesion and flexibly avoid unnecessary irradiation of surrounding sensitive tissues. The advantages of radiotherapy.
3.Super Gamma Knife treatment for bladder cancer is a safe, painless, low-injury and recently effective treatment method.