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Stereotactic Radiosurgery for Gynecologic Cancer
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CT-Guided Online Adaptive Stereotactic Body Radiotherapy (SBRT) for Retroperitoneal Sarcoma After Previous

Adham Hijab1, Yonina Tova1, Shlomi Alani1

  • 1Radiotherapy, Ziv Medical Centre, Safed, ISR.

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|October 14, 2024
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Summary

CT-guided online adaptive radiotherapy (OART) offers superior accuracy by adapting to daily changes, enabling reduced radiation doses to healthy tissues. This novel technique successfully treated a complex retroperitoneal sarcoma case with no adverse effects.

Keywords:
online-adaptive radiotherapyradiotherapy (rt)re-irradiationsarcomastereotactic ablative body radiotherapy

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Oncology

Background:

  • CT-guided online adaptive radiotherapy (OART) is an advanced technique improving treatment accuracy over standard image-guided radiotherapy (IGRT).
  • OART effectively compensates for inter-fraction variations, allowing for smaller planning target volumes (PTVs).
  • Reduced PTVs with OART can lead to decreased radiation dose in adjacent healthy tissues.

Observation:

  • A challenging case of retroperitoneal sarcoma, previously treated with radiotherapy and surgery, was managed using OART.
  • The tumor was located near the spinal canal, large bowel, and duodenum, posing significant treatment challenges.
  • The OART regimen involved 30 Gy in five fractions, delivered without interruption.

Findings:

  • Treatment implementation and delivery of OART were successful for this complex re-irradiation case.
  • The patient experienced no radiation-related adverse effects during a nine-month follow-up.
  • Post-treatment MRI scans indicated a favorable radiographic response to OART.

Implications:

  • OART demonstrates feasibility and efficacy in treating challenging, radio-resistant mesenchymal tumors, even in re-irradiation settings.
  • This case underscores OART's potential for precise dose delivery and improved outcomes in complex oncological cases.
  • The successful application of OART highlights its role in advancing radiotherapy for difficult-to-treat cancers.