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CC BY-NC-ND 4.0 · Asian Journal of Oncology 2022; 08(03): 164-167
DOI: 10.1055/s-0042-1751113
Case Report

Step-by-Step Guide to Surface Mold Applicator-Based Brachytherapy in a Case of Early Carcinoma Penis: An Organ-Preserving Approach

Purnima Thakur
1   Department of Radiotherapy, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
,
Manish Gupta
1   Department of Radiotherapy, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
,
Ranjan Gupta
2   Department of Prosthodontics, HP Government Dental College and Hospital, Shimla, Himachal Pradesh, India
,
Tarunjot Singh
1   Department of Radiotherapy, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
,
Neeraj Parihar
1   Department of Radiotherapy, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
,
Asha Ranjan
3   Department of Endocrinology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Abstract

Purpose In this report we discuss an individually customized surface mold applicator technique to treat a case of early carcinoma penis. This case report is one of its kind which describes the brachytherapy treatment planning based on orthogonal X-ray technique.

Material and methods T1N0 disease with squamous cell carcinoma histology involving the foreskin of penis and abutting the glans penis was treated by surface mold applicator technique. Impression of the organ was taken using alginate. Cast was prepared from the impression using Type 4 gypsum. The acrylic mold-based applicator was fabricated on the cast. The catheters were positioned and fixed on the acrylic mold. The organ is placed in the mold-based applicator and the catheters are reconstructed on two-dimensional imaging. The brachytherapy is delivered by the 18-channel high-dose rate Oncentra brachytherapy using Ir192 source. The dose given was 45 Gy in 15 fractions, twice daily more than 6 hours apart.

Results Patient was reviewed after 6 weeks for follow-up and there was complete regression of the ulcer. At present, patient is on follow-up for the last 10 months and is now disease-free.

Conclusion With judicious patient selection, surface mold brachytherapy is an attractive alternative to the interstitial brachytherapy. It is comfortable for the patient, is easily repeatable, and is time saving in high work load and limited resource settings. Early results with this technique are promising.

Keywords

brachytherapy - carcinoma penis - surface mold applicator

Consent

Written informed consent was taken from the patient.




Publication History

Article published online:
14 July 2022

© 2022. Spring Hope Cancer Foundation & Young Oncologist Group of Asia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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