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Intensity modulated radiation therapy (IMRT) for the treatment of unicentric Castlemans disease: a case report and review of the use of radiotherapy in the literature.

Matthiesen C, Ramgopol R, Seavey J, Ahmad S, Herman T - Radiol Oncol (2012)

Bottom Line: A 47 year old female was found to have an intra-thoracic posterior UCD and was determined not to be a good surgical candidate.Neither disease progression nor late effects have occurred.The use of IMRT and planned treatment break was successful in the treatment of a case of UCD, and should be considered for other unresectable cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

ABSTRACT

Background: Surgical resection is considered standard therapy for cases of resectable unicentric Castleman's disease (UCD). Unresectable cases of UCD do not have a consensus regarding the optimal treatment approach, but have utilized steroids, observation, chemotherapy, and radiotherapy. Here we discuss a patient presentation of UCD treated with an advanced radiotherapy technique, IMRT.

Case report: A 47 year old female was found to have an intra-thoracic posterior UCD and was determined not to be a good surgical candidate. She was referred for radiotherapy and was treated using IMRT to a total dose of 4320 cGy in 180 cGy fractions including a scheduled 10 day break. Following the break, the patient's treatment was replanned at which the initial treatment volume was reduced by 50.9% for the duration of the treatment course. Radiation Therapy Oncology Group (RTOG) grade III pneumonitis developed which was managed medically. Neither disease progression nor late effects have occurred.

Conclusions: The use of IMRT and planned treatment break was successful in the treatment of a case of UCD, and should be considered for other unresectable cases.

No MeSH data available.


Related in: MedlinePlus

CT of patient at initial presentation with a mass noted in the posterior right mediastinum.
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f1-rado-46-03-265: CT of patient at initial presentation with a mass noted in the posterior right mediastinum.

Mentions: The patient is a 47 year old Native American female without significant past medical history or known CD risk factors who presented after being critically injured in a motor vehicle accident. During her trauma evaluation and stabilization, a posterior mediastinal mass was noted as shown in Figure 1. She was taken to the operating room for multiple internal injuries necessitating surgical repair. Visualization of the mass was noted but was not attended to at that time. After a several month recovery, she returned to the thoracic surgeon for follow-up and further workup of the mass. Biopsy was performed via mediastinoscopy and pathology results revealed angiofollicular lymph node hyperplasia, consistent with CD. CT and PET-CT scans were performed which showed the mass to be 5.5 cm x 4.6 cm with a peak SUV of 5.3. Due to the location of the mass and history of recent prior surgery, she was determined not to be a good candidate for complete surgical resection. She was then referred to consider radiotherapy treatment options.


Intensity modulated radiation therapy (IMRT) for the treatment of unicentric Castlemans disease: a case report and review of the use of radiotherapy in the literature.

Matthiesen C, Ramgopol R, Seavey J, Ahmad S, Herman T - Radiol Oncol (2012)

CT of patient at initial presentation with a mass noted in the posterior right mediastinum.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3472945&req=5

f1-rado-46-03-265: CT of patient at initial presentation with a mass noted in the posterior right mediastinum.
Mentions: The patient is a 47 year old Native American female without significant past medical history or known CD risk factors who presented after being critically injured in a motor vehicle accident. During her trauma evaluation and stabilization, a posterior mediastinal mass was noted as shown in Figure 1. She was taken to the operating room for multiple internal injuries necessitating surgical repair. Visualization of the mass was noted but was not attended to at that time. After a several month recovery, she returned to the thoracic surgeon for follow-up and further workup of the mass. Biopsy was performed via mediastinoscopy and pathology results revealed angiofollicular lymph node hyperplasia, consistent with CD. CT and PET-CT scans were performed which showed the mass to be 5.5 cm x 4.6 cm with a peak SUV of 5.3. Due to the location of the mass and history of recent prior surgery, she was determined not to be a good candidate for complete surgical resection. She was then referred to consider radiotherapy treatment options.

Bottom Line: A 47 year old female was found to have an intra-thoracic posterior UCD and was determined not to be a good surgical candidate.Neither disease progression nor late effects have occurred.The use of IMRT and planned treatment break was successful in the treatment of a case of UCD, and should be considered for other unresectable cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

ABSTRACT

Background: Surgical resection is considered standard therapy for cases of resectable unicentric Castleman's disease (UCD). Unresectable cases of UCD do not have a consensus regarding the optimal treatment approach, but have utilized steroids, observation, chemotherapy, and radiotherapy. Here we discuss a patient presentation of UCD treated with an advanced radiotherapy technique, IMRT.

Case report: A 47 year old female was found to have an intra-thoracic posterior UCD and was determined not to be a good surgical candidate. She was referred for radiotherapy and was treated using IMRT to a total dose of 4320 cGy in 180 cGy fractions including a scheduled 10 day break. Following the break, the patient's treatment was replanned at which the initial treatment volume was reduced by 50.9% for the duration of the treatment course. Radiation Therapy Oncology Group (RTOG) grade III pneumonitis developed which was managed medically. Neither disease progression nor late effects have occurred.

Conclusions: The use of IMRT and planned treatment break was successful in the treatment of a case of UCD, and should be considered for other unresectable cases.

No MeSH data available.


Related in: MedlinePlus