3D Conformal Radiotherapy for Nephroblastoma: Unusual Technique in Dalal Jamm Hospital

Abstract

Nephroblastoma is the most common kidney tumor in children, accounting for 6% of all pediatric tumors. This tumor most commonly occurs between one and five years of age with a peak incidence around three and a half years. Multidisciplinary treatment combining neo-adjuvant chemotherapy followed by surgery and radiotherapy has achieved an overall survival of 90% at 10 years. This radiotherapy is optimal when it makes it possible to deliver an optimal dose of radiation while preserving the healthy developing organs in this subject. Conformational intensity modulation radiotherapy (IMRT) by linear accelerator or helical tomotherapy and hadrontherapy make it possible to respect this principle. These irradiation techniques were not available in our practice setting. We used a three-dimensional conformational radiotherapy technique for pan-abdominal irradiation of a nephroblasm while respecting the dosimetric constraints required in IMRT. Indeed, a rigorous optimization of three-dimensional conformational radiotherapy by a good delineation of the volumes of interest and a multiplication of the irradiation beams makes it possible to approach new radiotherapy techniques in terms of dose coverage, compliance with dosimetric constraints with reduction secondary cancer risk associated with low doses.