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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 Open the ORCID record for Anil Gupta [Opens in a new window] ,
Rambha Pandey ,
Anant Krishna ,
Rishabh Kumar ,
Seema Sharma ,
Rashmi Sarawagi  and
Kanika Garg
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]
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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.

Keywords

giant cell tumour of the tendon sheath (GCTTS)post-operative radiotherapysurface mould brachytherapy
Type
Case Study
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 2 , June 2022 , pp. 289 - 293
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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