Pediatric peri-operative fractionated high-dose-rate brachytherapy for recurrent Wilms’ tumor using a reconstructed Freiburg flap

• Main Authors: Emily Flower, Kathy Ngoc Tran, Salman Zanjani, Wayne Smith, Jonathan Karpelowsky, Katie Summerhayes, Edgar Estoesta, Jennifer Chard
• Format: Article
• Language: English
• Published: Termedia Publishing House 2016-10-01
• Series: Journal of Contemporary Brachytherapy
• Subjects: nephroblastoma; pediatric brachytherapy; peri-operative; Wilms tumor
• Online Access: https://www.termedia.pl/Pediatric-peri-operative-fractionated-high-dose-rate-brachytherapy-for-recurrent-Wilms-tumor-using-a-reconstructed-Freiburg-flap,54,28550,1,1.html
• ISSN: 1689-832X; 2081-2841

Purpose : To report peri-operative fractionated high-dose-rate (HDR) brachytherapy with a 3D customized Freiburg flap applicator to treat locally recurrent Wilms’ tumor, followed by immediate hyperthermic intraperitoneal chemotherapy for a 16-year-old with a second recurrence of nephroblastoma (Wilms’ tumor). Material and methods: The tumor was excised and surgical bed was treated with fractionated HDR brachytherapy using a Freiburg flap applicator. Hyperthermic intraperitoneal chemotherapy was performed immediately after the removal of brachytherapy applicator. Results: The Freiburg flap was successfully reconstructed to enable delivery of conformable peri-operative HDR brachytherapy. The clinical target volume (CTV) D90 was 26 Gy in 5 fractions. Conclusions : Peri-operative fractionated HDR brachytherapy with a customized Freiburg flap applicator was delivered successfully across a large multi-disciplinary team.