Title: Feasibility of Treating Superficial Complex Targets using Advanced Radiation Therapy Planning
Authors: Dr P.R.Vijey Karthik, Dr M.Sathiya
DOI: https://dx.doi.org/10.18535/jmscr/v7i3.55
Abstract
Aim: Superficial targets are those which either is on skin surface or within 1-2cm of skin surface. If the target is widespread and situated in conjunction with vital normal structures, it is complicated to treat. Here we discuss three situations, were we used megavoltage photons to treat scalp, face and combined scalp and face lesions.
Materials and Methods: One case is a verrucous carcinoma of scalp after excision of the tumours treated with radical radiation. He had good response with radiation and is on regular follow up. Next one is peripheral T cell lymphoma of the face which was resistant to chemotherapy. He also had excellent response to radiation and good palliation of symptoms, but due to the biology of the disease, he developed widespread disease. And a rare angiosarcoma of face and scalp, which was inoperable, and underwent PET-CT based planning for his lesion. He had satisfactory regression of the lesions.
Results: Good target coverage with acceptable normal tissue constraints was achieved in all the three cases and there was a good clinical regression of the tumours. Thus with modern planning techniques, complex targets can be treated adequately.
Conclusion: With improved technology complex superficial targets can be treated adequately with high energy photon beams.
Keywords: Dosimetry; superficial PTV; IMRT; VMAT
References
- Ward JR, Feigenberg SJ, Mendenhall NP, Marcus RB, Jr, Mendenhall WM. Radiation therapy for angiosarcoma. Head Neck 2003;25:873–8 [PubMed]
- Pawlik TM, Paulino AF, McGinn CJ, Baker LH, Cohen DS, Morris JS, et al. Cutaneous angiosarcoma of the scalp: a multidisciplinary approach. Cancer 2003;98:1716–26 [PubMed]
- Sasaki R, Soejima T, Kishi K, Imajo Y, Hirota S, Kamikonya N, et al. Angiosarcoma treated with radiotherapy: impact of tumor type and size on outcome. Int J Radiat Oncol Biol Phys 2002;52:1032–40 [PubMed]
- Nakamura R, Harada S, Obara T, Ehara S, Yoshida A, Akasaka T, et al. Iridium-192 brachytherapy for hemorrhagic angiosarcoma of the scalp: a case report. Jpn J Clin Oncol 2003;33:198–201 [PubMed]
- Bedford JL, Childs PJ, Hansen VN, Warrington AP, Mendes RL, Glees JP. Treatment of extensive scalp lesions with segmental intensity-modulated photon therapy. Int J Radiat Oncol Biol Phys 2005;62:1549–58 [PubMed]
- Pawlik TM, Paulino AF, McGinn CJ, et al. Cutaneous angiosarcoma of the scalp: a multidisciplinary approach. Cancer. 2003; 98(8):1716–26. [PubMed]
- Mark RJ, Poen JC, Tran LM, Fu YS, Juillard GF. Angiosarcoma. A report of 67 patients and a review of the literature. Cancer. 1996;77(11):2400–6. [PubMed]
- Ohguri T, Imada H, Nomoto S, et al. Angiosarcoma of the scalp treated with curative radiotherapy plus recombinant interleukin-2 immunotherapy. Int J Radiat Oncol Biol Phys. 2005;61(5):1446–53. [PubMed]
- Sasaki R, Soejima T, Kishi K, et al. Angiosarcoma treated with radiotherapy: impact of tumor type and size on outcome. Int J Radiat Oncol Biol Phys. 2002;52(4):1032–40. [PubMed]
- Specht L, Dabaja B, Illidge T, et al. Modern radiation therapy for primary cutaneous lymphomas: field and dose guidelines from the International Lymphoma Radiation Oncology Group. Int J Radiation Oncol Biol Phys.2015;92(1)32-39
- Teoh M, Clark CH, Wood K, Whitaker S, Nisbet A. Volumetric modulated arc therapy: A review of current literature and clinical use in practice. Br J Radiol. 2011;84:967-996.