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Perineal recurrence of prostate cancer six years after trans-perineal brachytherapy.

Eppinga W, Vijverberg P, Moerland R, Brand E, van der Voort van Zyp J, Noteboom J, van Vulpen M - J Contemp Brachytherapy (2014)

Bottom Line: We report a case of perineal recurrence of prostate cancer 6 years after low-dose-rate (LDR) brachytherapy for localized prostate cancer.The most common approach to treat such perineal masses, including those occurring after prior biopsy or surgery, is local excision.We report the use of stereotactic radiotherapy with volumetric modulated arc therapy (VMAT) as a novel non-invasive, potentially curative, and patient-friendly alternative to local excision.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, University Medical Center Utrecht, The Netherlands.

ABSTRACT
We report a case of perineal recurrence of prostate cancer 6 years after low-dose-rate (LDR) brachytherapy for localized prostate cancer. The most common approach to treat such perineal masses, including those occurring after prior biopsy or surgery, is local excision. We report the use of stereotactic radiotherapy with volumetric modulated arc therapy (VMAT) as a novel non-invasive, potentially curative, and patient-friendly alternative to local excision.

No MeSH data available.


Related in: MedlinePlus

Axial and coronal view of perineal metastasis (red line), prescribed dose of 35 Gy (red color wash) and 25 Gy (green color wash). Anal canal (purple) with lead string for demarcation
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Figure 0002: Axial and coronal view of perineal metastasis (red line), prescribed dose of 35 Gy (red color wash) and 25 Gy (green color wash). Anal canal (purple) with lead string for demarcation

Mentions: A volumetric modulated arc therapy (VMAT) plan was created. This type of therapy is a relatively new form of delivering radiation to a target volume by rotating the gantry of the linear accelerator around the patient with the radiation beam continuously on. While the gantry is rotating with the beam on, the gantry speed, beam shape, and output (dose rate) are modulated according to the optimized treatment plan. Using VMAT, the total treatment time can be significantly reduced, while even better coverage of the tumor or sparing of OAR can be achieved compared to more conventional radiotherapy techniques. The patient was treated to a dose of 35 Gy in 5 fractions to the tumor with acceptable low dose to surrounding OAR (Fig. 2). To confirm accurate setup, 2 gold markers were implanted into the perineal nodule under ultrasound guidance. These fiducials were used for daily online imaging to ensure accurate targeting. All 5 fractions were delivered within 2 weeks on outpatient basis. For each treatment session, the average time in the treatment room was 10 minutes, and beam-on time was approximately 3 minutes.


Perineal recurrence of prostate cancer six years after trans-perineal brachytherapy.

Eppinga W, Vijverberg P, Moerland R, Brand E, van der Voort van Zyp J, Noteboom J, van Vulpen M - J Contemp Brachytherapy (2014)

Axial and coronal view of perineal metastasis (red line), prescribed dose of 35 Gy (red color wash) and 25 Gy (green color wash). Anal canal (purple) with lead string for demarcation
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4300357&req=5

Figure 0002: Axial and coronal view of perineal metastasis (red line), prescribed dose of 35 Gy (red color wash) and 25 Gy (green color wash). Anal canal (purple) with lead string for demarcation
Mentions: A volumetric modulated arc therapy (VMAT) plan was created. This type of therapy is a relatively new form of delivering radiation to a target volume by rotating the gantry of the linear accelerator around the patient with the radiation beam continuously on. While the gantry is rotating with the beam on, the gantry speed, beam shape, and output (dose rate) are modulated according to the optimized treatment plan. Using VMAT, the total treatment time can be significantly reduced, while even better coverage of the tumor or sparing of OAR can be achieved compared to more conventional radiotherapy techniques. The patient was treated to a dose of 35 Gy in 5 fractions to the tumor with acceptable low dose to surrounding OAR (Fig. 2). To confirm accurate setup, 2 gold markers were implanted into the perineal nodule under ultrasound guidance. These fiducials were used for daily online imaging to ensure accurate targeting. All 5 fractions were delivered within 2 weeks on outpatient basis. For each treatment session, the average time in the treatment room was 10 minutes, and beam-on time was approximately 3 minutes.

Bottom Line: We report a case of perineal recurrence of prostate cancer 6 years after low-dose-rate (LDR) brachytherapy for localized prostate cancer.The most common approach to treat such perineal masses, including those occurring after prior biopsy or surgery, is local excision.We report the use of stereotactic radiotherapy with volumetric modulated arc therapy (VMAT) as a novel non-invasive, potentially curative, and patient-friendly alternative to local excision.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, University Medical Center Utrecht, The Netherlands.

ABSTRACT
We report a case of perineal recurrence of prostate cancer 6 years after low-dose-rate (LDR) brachytherapy for localized prostate cancer. The most common approach to treat such perineal masses, including those occurring after prior biopsy or surgery, is local excision. We report the use of stereotactic radiotherapy with volumetric modulated arc therapy (VMAT) as a novel non-invasive, potentially curative, and patient-friendly alternative to local excision.

No MeSH data available.


Related in: MedlinePlus