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Radiation therapy in wilms tumour

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Kidwai Memorial Institute of Oncology, Bangalore
Kidwai Memorial Institute of Oncology, Bangalore

1. Radiation therapy plays an important role in the treatment of Wilms tumor, especially for advanced or high-risk cases. 2. It is used preoperatively, postoperatively, and for metastatic disease to reduce the risk of recurrence. 3. The indications and techniques for radiation therapy depend on factors like tumor stage, histology, response to chemotherapy, and whether metastases are present. Precise radiation treatment planning is required to effectively target tumors while sparing healthy tissues.

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Radiation therapy in Wilms Tumor ,[object Object],[object Object],[object Object]
Radiation Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Roles of Radiotherapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Indications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
RT - Indications : Post OP RT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
RT Technique ,[object Object],[object Object]
RT Machines ,[object Object],[object Object]
RT Techniques ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
General Principles : RT planning ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
RT Dose CCSK Diffuse anaplasia Focal anaplasia Stage I-III FLANK RT : 10.8Gy , 180cGy/fx FH Stage III RTK Stage I-III FLANK RT : 19.8Gy (Infants -10.8Gy), 180cGy/fx Diffuse anaplasia Stage III
+ 10Gy Renal Shielding / Limit the dose to remaining kidney <14.4Gy Residual Boost 19.8Gy in 11# Unresected Lymph nodes 12Gy WLI in 8# FH / UH Lung (mets.) 19.8Gy WLivI in 11# Liver (mets.) 10Gy, 150cGy/Fx FH Whole Abdomen RT 25.2 Gy in 14# Bone (mets.) 36.6Gy WB in 17# Or 21.6Gy WB + 10.8Gy IMRT /SRST Boost Brain (mets.)
Flank Radiation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment Fields - Flank
Whole Abdomen Radiation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
Lung Irradiation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
bilateral Wilms’ ,[object Object],[object Object]
Long-term results of NWTS-3 and -4
Results – 4yrs – FH (NWTS 5) 93.9% 85.3% III Lung Mets, Pulm RT 74.6% IV 92% 83% II 98% 92% I EFS OS RFS Stage
Results UH (NWTS 5) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conclusion ,[object Object],[object Object],[object Object],[object Object]
Thank You

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Radiation therapy in wilms tumour

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  • 10. RT Dose CCSK Diffuse anaplasia Focal anaplasia Stage I-III FLANK RT : 10.8Gy , 180cGy/fx FH Stage III RTK Stage I-III FLANK RT : 19.8Gy (Infants -10.8Gy), 180cGy/fx Diffuse anaplasia Stage III
  • 11. + 10Gy Renal Shielding / Limit the dose to remaining kidney <14.4Gy Residual Boost 19.8Gy in 11# Unresected Lymph nodes 12Gy WLI in 8# FH / UH Lung (mets.) 19.8Gy WLivI in 11# Liver (mets.) 10Gy, 150cGy/Fx FH Whole Abdomen RT 25.2 Gy in 14# Bone (mets.) 36.6Gy WB in 17# Or 21.6Gy WB + 10.8Gy IMRT /SRST Boost Brain (mets.)
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  • 21. Long-term results of NWTS-3 and -4
  • 22. Results – 4yrs – FH (NWTS 5) 93.9% 85.3% III Lung Mets, Pulm RT 74.6% IV 92% 83% II 98% 92% I EFS OS RFS Stage
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