HEAPHY 1 & 2CASE RACE 2 – RT

Jemma HURLEY

Sat 31st Aug 2013Session 3 / CR2-4

13:51 – 13:55

CANTERBURY / WESTLAND

ABSTRACTThis case follows the Radiation Treatment Planning process for a recurrent Glioblastoma Multiforme Brain patient. This patient received two courses of RT to the same site resulting in a total dose of 100Gy to the brain. Interesting points to be covered include patient history, RO prescription choice and associated evidence, planning process and patient implications. This case study will be focused on planning rather than treatment.

CASE RACE100GY BRAIN

Jemma HurleyRadiation Therapist Canterbury District Health Board

Patient Information 58 year old Female Diagnosis: Glioblastoma Multiforme Site: Left Brain

Patient History May 2011: Surgical debulking GBM June 2011: Commenced Radiation Therapy

concurrent w Temozolomide July 2011: Completed RT Jan 2012: Completed 6th cycle Temozolomide

Nov 2012: Recurrent dysphagia & headaches Dec 2012: Debulking recurrent GBM

commenced PCV chemo March 2013: MRI progression May 2013: Commenced Course 2 Radiation Therapy

Prescription Course 1: 60Gy/30# to Left Brain Course 2: 40Gy/20# to Left Brain

Total Dose to Left Brain = 100Gy

Planning Principles

Volumes Location of tumour made 100Gy

possible Screen dump

Course 1

Course 2

Composite C1/C2

DVHs composite plan

Patient Implications Brain Necrosis

Only significant after 100GyBrain can recover

Benefit versus Risk Survival

Further 5 months

References Short SC. Re-irradiation of brain

tumours – evidence, indications and limitations. European journal of cancer. 2009.