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Whole abdominopelvic radiotherapy in the palliative treatment of pseudomyxoma peritonei

(2014) STRAHLENTHERAPIE UND ONKOLOGIE. 190(2). p.223-228
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Abstract
Background. Pseudomyxoma peritonei (PMP) is a rare clinical syndrome characterized by mucinous peritoneal disease arising from disseminated peritoneal adenomucinosis. Primary treatment involves a combination of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC). There is no consensus on the proper treatment of recurrent PMP. In selected patients, repeated cytoreductive surgery with or without HIPEC might improve outcome. However, every repeated debulking procedure becomes less effective with increased morbidity. Case report. We present a case of a patient with intestinal obstruction caused by recurrent pseudomyxoma peritonei. We treated the patient with whole abdominopelvic radiotherapy (WAPRT) using intensity-modulated arc therapy (IMAT) to a total dose of 33 Gy, delivered in 22 daily fractions. The treatment was well tolerated and resulted in resolution of the obstruction for a period of 24 months. Conclusion. To the best of our knowledge, we present the first case report showing the possibility of resolving intestinal obstruction with WAPRT in a patient with recurrent PMP. It is our opinion that WAPRT delivered by IMAT, in analogy with ovarian cancer, should be considered as a palliative treatment option in managing patients with recurrent PMP especially in case of obstruction.
Keywords
Whole abdominopelvic radiotherapy, Recurrent pseudomyxoma peritonei, WAPRT, Intensity-modulated arc therapy, Abdominal obstruction, APPENDICEAL MUCINOUS NEOPLASMS, INTRAPERITONEAL CHEMOTHERAPY, CYTOREDUCTIVE SURGERY, OVARIAN-CANCER, ADENOMUCINOSIS, CARCINOMATOSIS, DISSEMINATION, IRRADIATION, PROGNOSIS, THERAPY

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Chicago
BERKOVIC, PATRICK, LIEN VAN DE VOORDE, Gert De Meerleer, Louke Delrue, Bruno Speleers, Simon Van Belle, and Katrien Vandecasteele. 2014. “Whole Abdominopelvic Radiotherapy in the Palliative Treatment of Pseudomyxoma Peritonei.” Strahlentherapie Und Onkologie 190 (2): 223–228.
APA
BERKOVIC, P., VAN DE VOORDE, L., De Meerleer, G., Delrue, L., Speleers, B., Van Belle, S., & Vandecasteele, K. (2014). Whole abdominopelvic radiotherapy in the palliative treatment of pseudomyxoma peritonei. STRAHLENTHERAPIE UND ONKOLOGIE, 190(2), 223–228.
Vancouver
1.
BERKOVIC P, VAN DE VOORDE L, De Meerleer G, Delrue L, Speleers B, Van Belle S, et al. Whole abdominopelvic radiotherapy in the palliative treatment of pseudomyxoma peritonei. STRAHLENTHERAPIE UND ONKOLOGIE. 2014;190(2):223–8.
MLA
BERKOVIC, PATRICK, LIEN VAN DE VOORDE, Gert De Meerleer, et al. “Whole Abdominopelvic Radiotherapy in the Palliative Treatment of Pseudomyxoma Peritonei.” STRAHLENTHERAPIE UND ONKOLOGIE 190.2 (2014): 223–228. Print.
@article{4251013,
  abstract     = {Background. Pseudomyxoma peritonei (PMP) is a rare clinical syndrome characterized by mucinous peritoneal disease arising from disseminated peritoneal adenomucinosis. Primary treatment involves a combination of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC). There is no consensus on the proper treatment of recurrent PMP. In selected patients, repeated cytoreductive surgery with or without HIPEC might improve outcome. However, every repeated debulking procedure becomes less effective with increased morbidity. 
Case report. We present a case of a patient with intestinal obstruction caused by recurrent pseudomyxoma peritonei. We treated the patient with whole abdominopelvic radiotherapy (WAPRT) using intensity-modulated arc therapy (IMAT) to a total dose of 33 Gy, delivered in 22 daily fractions. The treatment was well tolerated and resulted in resolution of the obstruction for a period of 24 months. 
Conclusion. To the best of our knowledge, we present the first case report showing the possibility of resolving intestinal obstruction with WAPRT in a patient with recurrent PMP. It is our opinion that WAPRT delivered by IMAT, in analogy with ovarian cancer, should be considered as a palliative treatment option in managing patients with recurrent PMP especially in case of obstruction.},
  author       = {BERKOVIC, PATRICK and VAN DE VOORDE, LIEN and De Meerleer, Gert and Delrue, Louke and Speleers, Bruno and Van Belle, Simon and Vandecasteele, Katrien},
  issn         = {0179-7158},
  journal      = {STRAHLENTHERAPIE UND ONKOLOGIE},
  keyword      = {Whole abdominopelvic radiotherapy,Recurrent pseudomyxoma peritonei,WAPRT,Intensity-modulated arc therapy,Abdominal obstruction,APPENDICEAL MUCINOUS NEOPLASMS,INTRAPERITONEAL CHEMOTHERAPY,CYTOREDUCTIVE SURGERY,OVARIAN-CANCER,ADENOMUCINOSIS,CARCINOMATOSIS,DISSEMINATION,IRRADIATION,PROGNOSIS,THERAPY},
  language     = {eng},
  number       = {2},
  pages        = {223--228},
  title        = {Whole abdominopelvic radiotherapy in the palliative treatment of pseudomyxoma peritonei},
  url          = {http://dx.doi.org/10.1007/s00066-013-0470-7},
  volume       = {190},
  year         = {2014},
}

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