P. Zhang, R. Luo, P. Dai, Q. Huang, M. Lai, and L. Cai; Guangdong Sanjiu Brain Hospital, Guangzhou, China
Purpose/Objective(s): Patients with critical intracranial tumors often face rapidly changing and life-threatening conditions, leading to high mortality rates.Many patients transferred to our hospital had tumor progression, severe conditions, and symptoms such as consciousness disorders, bedridden states, and comas.Emergency radiotherapy is combined with other treatment modalities, such as chemotherapy,targeted therapy or surgery, to achieve favorable outcomes. Materials/
Methods: The emergency radiotherapy protocol involves initiating an emergency plan, completing CT simulation, image fusion, target coutouring, and designing treatment plans within one working day. After planning, the first radiotherapy session is conducted with the patient. Various proactive and effective measures are taken during radiotherapy to ensure the stability of the patients vital signs. These measures include tracheal intubation, nasogastric tube placement, ventricular shunt tube placement, lumbar cistern drainage tube placement, low-flow oxygen therapy, monitoring of oxygen saturation, and the presence of attending physicians or ICU doctors. Radiation therapy technicians are trained in resuscitation measures such as cardiopulmonary resuscitation and suctioning. The radiotherapy room is equipped with various rescue items to ensure the smooth implementation of emergency radiotherapy for critically neursurgical patients. Results: Approximately 40 critically neursurgical patients underwent emergency radiotherapy at our hospital last year, including 11 children and 29 adults. Radiotherapy is completed in 37 patients(92.5%), and terminated in 3 patients (7.5%). The Karnofsky Performance Status (KPS) score improves after radiotherapy compared to before (55.6±15.7 vs. 42.3±14.5, p=0.026), with statistically significant differences. The positioning errors in X, Y, and Z axes for head placement are 0.89±0.72mm, 0.88±0.70mm, and 0.65±0.66mm respectively, which are below the clinically required 2mm error range. For body placement, the errors in the X, Y, and Z axes are (0.74±0.99)mm, (1.71±1.24)mm, and (0.56±0.92)mm respectively, which are below the clinically required 5mm error range. Conclusion: Patients with acute and critical illness should start radiotherapy as quickly as possible, to control the tumor and save organ function or life as early. Emergency radiotherapy can be used to relieve or eliminate the mass efffect,improve life quality and overall survival rate in critical nerve tumors. Emergency radiotherapy has become one of the key therapeutic approaches for critical nerve tumors in our hospital.
