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Surface mould brachytherapy planning in giant cell tumour of the tendon sheath of finger and dosimetric comparison with external beam radiotherapy: a case report

Published online by Cambridge University Press:  10 November 2020

Anil Gupta*
Affiliation:
Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi, India
Rambha Pandey
Affiliation:
Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi, India
Anant Krishna
Affiliation:
Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi, India
Rishabh Kumar
Affiliation:
Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi, India
Seema Sharma
Affiliation:
Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi, India
Rashmi Sarawagi
Affiliation:
Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi, India
Kanika Garg
Affiliation:
Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi, India
*
Author for correspondence: Anil Gupta, Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi, India. E-mail: [email protected]

Abstract

Introduction:

Giant cell tumour of the tendon sheath (GCTTS) is the second most common tumour of the hand. Despite surgery, local recurrence after excision has been reported in up to 45% of cases. Post-operative radiotherapy (PORT) has been found to be promising in preventing these recurrences in high-risk group. One of the reservations of PORT is secondary effects of radiation which may cause a decreased range of motion of the affected joint, sensory changes and nail changes. Surface mould brachytherapy can provide a high dose to target volume with a rapid fall of dose to surrounding structures. Despite this, it is less used, the possible reason can be less technical proficiency.

Methods:

We have technically illustrated surface mould brachytherapy in a case of GCTTS of the left index finger, and compared dosimetrically with more widely used conventional photon and electron external beam radiotherapy.

Conclusion:

The 6-MV photon treatment plan with a bolus plan provided the least dose to skin (106%) and phalanges (103%). It has a Homogeneity index (1·06) closest to 1, whereas the Conformity index of all plans was similar. The dose coverage was adequate in all plans. The second-best plan dosimetrically was the surface mould brachytherapy.

Type
Case Study
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Coroneos, CJ, O’Sullivan, B, Ferguson, PC, Chung, PW, Anastakis, DJ. Radiation therapy for infiltrative giant cell tumor of the tendon sheath. J Hand Surg Am 2012; 37(4): 775782. doi: 10.1016/j.jhsa.2012.01.011 CrossRefGoogle ScholarPubMed
Ozben, H, Coskun, T. Giant cell tumor of tendon sheath in the hand: analysis of risk factors for recurrence in 50 cases. BMC Musculoskelet Disord 2019; 20(1): 18. doi: 10.1186/s12891-019-2866-8 CrossRefGoogle ScholarPubMed
Kotwal, PP, Gupta, V, Malhotra, R. Giant-cell tumour of the tendon sheath: Is radiotherapy indicated to prevent recurrence after surgery? J Bone Joint Surg Ser B 2000; 82(4): 571573. doi: 10.1302/0301-620X.82B4.10328 CrossRefGoogle ScholarPubMed
Steen, K, Hayward, V, Novak, C, Anastakis, D, McCabe, S. Secondary effects of radiation therapy to the hand for benign conditions. Hand 2020; 15(3): 341347. doi: 10.1177/1558944718810891 CrossRefGoogle Scholar
Di Grazia, S, Succi, G, Fraggetta, F, Perrotta, RE. Giant cell tumor of tendon sheath: study of 64 cases and review of literature. G Chir 2013; 34(5–6): 149152. doi: 10.11138/gchir/2013.34.5.149 Google ScholarPubMed
O’Sullivan, B, Cummings, B, Catton, C et al. Outcome following radiation treatment for high-risk pigmented villonodular synovitis. Int J Radiat Oncol Biol Phys 1995; 32(3): 777786. doi: 10.1016/0360-3016(95)00514-Y CrossRefGoogle ScholarPubMed
Goda, JS, Patil, P, Krishnappan, C, Elangovan, D. Giant cell tumor of the tendon sheath treated by brachytherapy (surface mold) technique-A technical illustration. Brachytherapy 2009; 8(1): 7983. doi: 10.1016/j.brachy.2008.07.008 CrossRefGoogle ScholarPubMed
Kataria, T, Sharma, K, Subramani, V, Karrthick, KP, Bisht, SS. Homogeneity index: an objective tool for assessment of conformal radiation treatments. J Med Phys 2012; 37(4): 207213. doi: 10.4103/0971-6203.103606 CrossRefGoogle ScholarPubMed
Feuvret, L, Noël, G, Mazeron, JJ, Bey, P. Conformity index: A review. Int J Radiat Oncol Biol Phys 2006; 64(2): 333342. doi: 10.1016/j.ijrobp.2005.09.028 CrossRefGoogle ScholarPubMed
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