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Technical illustration of Volumetric arc conformal radiotherapy planning in a case of paratesticular sarcoma

Published online by Cambridge University Press:  18 January 2021

Anil Gupta Open the ORCID record for Anil Gupta [Opens in a new window] ,
Rambha Pandey Open the ORCID record for Rambha Pandey [Opens in a new window] ,
Seema Sharma ,
Vivek Ghosh ,
Ekta Dhamija ,
Adarsh Barwad ,
Sameer Rastogi ,
Rishabh Kumar  and
Rashi Kulshrestha
Anil Gupta
Affiliation:
Radiation Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Delhi 110029, India
Rambha Pandey*
Affiliation:
All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Delhi110029, India
Seema Sharma
Affiliation:
Radiation Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Delhi 110029, India
Vivek Ghosh
Affiliation:
Radiation Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Delhi 110029, India
Ekta Dhamija
Affiliation:
Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Delhi 110029, India
Adarsh Barwad
Affiliation:
Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Delhi 110029, India
Sameer Rastogi
Affiliation:
Medical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Delhi 110029, India
Rishabh Kumar
Affiliation:
All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Delhi110029, India
Rashi Kulshrestha
Affiliation:
British Columbia Cancer Agency, Radiation Oncology, 32900, Marshall Road, Abbotsford, British ColumbiaV2S 0C2, Canada
*
Author for correspondence: Rambha Pandey, Department of Radiation Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Delhi 110029, India. E-mail: [email protected]
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Abstract

Introduction:

Paratesticular sarcoma are extremely rare malignant tumours. Unlike other sites, they tend to be lower grade and have higher propensity of lymphatic spread. They tend to fail locally and occasionally in the regional lymph nodes. In the absence of target volume delineation guidelines and technical illustration of conformal planning, we have made an attempt to illustrate conformal planning methodology and define target volume based on current evidence in a case of paratesticular sarcoma.

Methods:

We are presenting a case of 62-year-old male who presented with 15-cm scrotal swelling and underwent high inguinal orchidectomy with ligation of spermatic cord. Histopathology presented a well-differentiated leiomyosarcoma of epididymis. Post-operative radiotherapy target volume included the tumour bed, ipsilateral inguinal nodes and lower pelvic nodes as the clinical target volume.

Conclusion:

Adjuvant radiotherapy using advanced delivery technique such as volumetric arc technique can provide good dose distribution with good sparing of organs at risk. The downside of conformal radiation delivery is that it is a resource-intensive and has no established target volume delineation guidelines.

Keywords

paratesticular sarcomapost-operative radiotherapyradiotherapy planningtarget volume delineation
Type
Case Study
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 3 , September 2022 , pp. 446 - 451
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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