Definitive radiotherapy for locally advanced squamous cell carcinoma of the vulva and technical issues: a case report

This case report describes a complex radical 3D-Conformal Radiotherapy treatment planning, dosimetric issues and outcome of definitive treatment of un-resectable carcinoma of the vulvar in a 42-year old lady. The patient presented with large fungating mass of the vulva which was biopsy confirmed...

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Main Authors: Appalanaido, Gokula Kumar, I, Norhafizah, I, Shazril, AR, Nursyatina, MZ, Abdul Aziz, Mohd Zin, Mohd Hafiz, MK, Zakir, J, Norjayadi, AS, Norliza, A, Ismail, N, Khairun
Format: Article
Language:English
Published: IOP Publishing 2017
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Online Access:http://eprints.usm.my/37330/1/Kumar_2017_J_Phys_012041.pdf
http://eprints.usm.my/37330/
https://doi.org/10.1088/1742-6596/851/1/012041
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Institution: Universiti Sains Malaysia
Language: English
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spelling my.usm.eprints.37330 http://eprints.usm.my/37330/ Definitive radiotherapy for locally advanced squamous cell carcinoma of the vulva and technical issues: a case report Appalanaido, Gokula Kumar I, Norhafizah I, Shazril AR, Nursyatina MZ, Abdul Aziz Mohd Zin, Mohd Hafiz MK, Zakir J, Norjayadi AS, Norliza A, Ismail N, Khairun RL Dermatology This case report describes a complex radical 3D-Conformal Radiotherapy treatment planning, dosimetric issues and outcome of definitive treatment of un-resectable carcinoma of the vulvar in a 42-year old lady. The patient presented with large fungating mass of the vulva which was biopsy confirmed as Keratinizing Squamous Cell Carcinoma. Further staging investigation revealed locally advanced disease (T4), with bilateral inguinal lymph nodes involvement. There is no systemic metastasis or intra-pelvic nodes. The patient was seen by Gynae-Oncology team and the disease was deemed un-resectable without significant morbidity. She was treated to a total dose of 64.8Gy in 36 fractions over 7 weeks with concurrent weekly Cisplatinum in 2 phases. 3D-Conformal radiotherapy technique using the modified segmental boost technique (MSBT, large PA and small AP photon fields with inguinal electron matching) was used. TLD chips were used for in-vivo dose verification in phase 1 and 2 of the treatment. At completion of planned radiotherapy, patient had a complete clinical response, grade 2-3 skin toxicity, grade 2 rectal toxicity, and grade 2 dysuria Vulval Squamous Cell Carcinomas are very radiosensitive tumours and the skills of the treating Radiation Oncologist, Dosimetrists, Physicist, Radiation Therapist and also nurses is of foremost importance is ensuring good clinical outcomes. IOP Publishing 2017 Article PeerReviewed application/pdf en cc_by http://eprints.usm.my/37330/1/Kumar_2017_J_Phys_012041.pdf Appalanaido, Gokula Kumar and I, Norhafizah and I, Shazril and AR, Nursyatina and MZ, Abdul Aziz and Mohd Zin, Mohd Hafiz and MK, Zakir and J, Norjayadi and AS, Norliza and A, Ismail and N, Khairun (2017) Definitive radiotherapy for locally advanced squamous cell carcinoma of the vulva and technical issues: a case report. Journal of Physics: Conference Series, 851 (1). pp. 1-6. ISSN 1742-6588 https://doi.org/10.1088/1742-6596/851/1/012041
institution Universiti Sains Malaysia
building Hamzah Sendut Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Sains Malaysia
content_source USM Institutional Repository
url_provider http://eprints.usm.my/
language English
topic RL Dermatology
spellingShingle RL Dermatology
Appalanaido, Gokula Kumar
I, Norhafizah
I, Shazril
AR, Nursyatina
MZ, Abdul Aziz
Mohd Zin, Mohd Hafiz
MK, Zakir
J, Norjayadi
AS, Norliza
A, Ismail
N, Khairun
Definitive radiotherapy for locally advanced squamous cell carcinoma of the vulva and technical issues: a case report
description This case report describes a complex radical 3D-Conformal Radiotherapy treatment planning, dosimetric issues and outcome of definitive treatment of un-resectable carcinoma of the vulvar in a 42-year old lady. The patient presented with large fungating mass of the vulva which was biopsy confirmed as Keratinizing Squamous Cell Carcinoma. Further staging investigation revealed locally advanced disease (T4), with bilateral inguinal lymph nodes involvement. There is no systemic metastasis or intra-pelvic nodes. The patient was seen by Gynae-Oncology team and the disease was deemed un-resectable without significant morbidity. She was treated to a total dose of 64.8Gy in 36 fractions over 7 weeks with concurrent weekly Cisplatinum in 2 phases. 3D-Conformal radiotherapy technique using the modified segmental boost technique (MSBT, large PA and small AP photon fields with inguinal electron matching) was used. TLD chips were used for in-vivo dose verification in phase 1 and 2 of the treatment. At completion of planned radiotherapy, patient had a complete clinical response, grade 2-3 skin toxicity, grade 2 rectal toxicity, and grade 2 dysuria Vulval Squamous Cell Carcinomas are very radiosensitive tumours and the skills of the treating Radiation Oncologist, Dosimetrists, Physicist, Radiation Therapist and also nurses is of foremost importance is ensuring good clinical outcomes.
format Article
author Appalanaido, Gokula Kumar
I, Norhafizah
I, Shazril
AR, Nursyatina
MZ, Abdul Aziz
Mohd Zin, Mohd Hafiz
MK, Zakir
J, Norjayadi
AS, Norliza
A, Ismail
N, Khairun
author_facet Appalanaido, Gokula Kumar
I, Norhafizah
I, Shazril
AR, Nursyatina
MZ, Abdul Aziz
Mohd Zin, Mohd Hafiz
MK, Zakir
J, Norjayadi
AS, Norliza
A, Ismail
N, Khairun
author_sort Appalanaido, Gokula Kumar
title Definitive radiotherapy for locally advanced squamous cell carcinoma of the vulva and technical issues: a case report
title_short Definitive radiotherapy for locally advanced squamous cell carcinoma of the vulva and technical issues: a case report
title_full Definitive radiotherapy for locally advanced squamous cell carcinoma of the vulva and technical issues: a case report
title_fullStr Definitive radiotherapy for locally advanced squamous cell carcinoma of the vulva and technical issues: a case report
title_full_unstemmed Definitive radiotherapy for locally advanced squamous cell carcinoma of the vulva and technical issues: a case report
title_sort definitive radiotherapy for locally advanced squamous cell carcinoma of the vulva and technical issues: a case report
publisher IOP Publishing
publishDate 2017
url http://eprints.usm.my/37330/1/Kumar_2017_J_Phys_012041.pdf
http://eprints.usm.my/37330/
https://doi.org/10.1088/1742-6596/851/1/012041
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