Proton therapy versus photon radiation therapy for the management of a recurrent desmoid tumor of the right flank: a case report

Radiation Oncology

Daniel J Indelicato³  Robert B Marcus³  Pratibha Gupta²  Meng Wei Ho³  Soon Y Huh³  John W Kilkenny¹  R Charles Nichols³  Whoon Jong Kil³ 

[1] Department of Surgery University of Florida Shands Hospital, Jacksonville, FL, USA;Department of Radiology University of Florida Shands Hospital, Jacksonville, FL, USA;University of Florida Proton Therapy Institute, Jacksonville, FL, USA

关键词: Case report;    Benign tumors;    Intensity-modulated radiotherapy;    Proton therapy;   

Others  :  1155150
DOI  :  10.1186/1748-717X-7-178

 received in 2012-08-03, accepted in 2012-10-19,  发布年份 2012

【 摘 要 】

Desmoid tumors are benign mesenchymal tumors with a strong tendency for local recurrence after surgery. Radiotherapy improves local control following incomplete resection, but nearby organs at risk may limit the dose to the target volume. The patient in this report presented with a recurrent desmoid tumor of the right flank and underwent surgery with microscopically positive margins. Particular problems presented in this case included that the tumor bed was situated in close proximity to the liver and the right kidney and that the right kidney was responsible for 65% of the patient’s renal function. Intensity-modulated radiation therapy plans delivering 54 Gy necessarily exposed the right kidney to a V₁₈ of 98% and the liver to a V₃₀ of 55%. Proton therapy plans significantly reduced the right kidney V₁₈ to 32% and the liver V₃₀ to 28%. In light of this, the proton plan was utilized for treatment of this patient. Proton therapy was tolerated without gastrointestinal discomfort or other complaints. Twenty-four months after initiation of proton therapy, the patient is without clinical or radiographic evidence of disease recurrence. In this setting, the improved dose distribution associated with proton therapy allowed for curative treatment of a patient who arguably could not have been safely treated with intensity-modulated radiation therapy or other methods of conventional radiotherapy.

【 授权许可】

   
2012 Kil et al.; licensee BioMed Central Ltd.

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