ORGAN PRESERVATION AT MGCHRI

1. Organ preservation at MGCHRI
A NOBLE APPROACH

2. DISCLAIMER

5. 23rd JUNE 201O

6. TOTAL BRACHYTHERAPY
ICRT IBT OTHER SITE
10988 767/1414 18
1. LIP
2. BUCCAL MUCOSA
3. SARCOMA
4. BREAST
5. TONGUE
6. ESOPHAGUS
7. HARDPALATE

7. 25th JUNE 2016
27 ICRT

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11. PROCEDURE
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12. • GOOD COSMETIC
• FUNCTIONAL PRESERVATION
• GOOD QUALITY OF LIFE
• ESTABLISHED PROCEDURE
• EXPERTISE REQUIRED
• AVAILABLE LITERATURES
• LESS TOXIC
FACTS
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13. • HEAD AND NECK CANCERS
• BREAST CANCERS
• ESOPHAGUS CANCERS
• PENILE CANCER
• SOFT TISSUE SARCOMA
• BLADDER CANCERS
• CANAL CANCERS
ORGAN PRESERVATION
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16. ICA HDR application
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Dose prescription and Treatment
delivery
• Dose: 34Gy in 10 fraction bid
• Dose per fraction: 340cGy

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Mahatma Gandhi Cancer Hospital &
Research Institute,Visakhapatnanm
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36. Applicator in situ with IOP

37. Complete response –towards healing
hypo-pigmentation

38. Recent

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Mahatma Gandhi Cancer Hospital &
Research Institute,Visakhapatnanm
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Mahatma Gandhi Cancer Hospital &
Research Institute,Visakhapatnanm
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42. Ca. Lip(MDSqC), T2N0M0, ulcerated tumor 2.5x1.5 cm. underwent ISBT
4.5Gy per fraction twice daily with 6 hours interval for 10 fractions over
6 days.EQD2 calculated was 66.9 Gy
Catheter inserted
under LA
Grade ¾ toxicity at 6
weeks
At the end of 3
months
After 6 months
Case 1
Toxicity
DVH
Dr P S Bhattacharyya/Dr K C patro

43. A recurrent ca. Tongue. Initially he had a 3x2x2 cm lesion in the left lateral aspect of tongue. Underwent
WLE+MRND( Oct., 2013) PT2N0M0 ,followed by adjuvant RT (depth was more than 1 cm). After 38 months follow up
he developed a central recurrence in the tongue of 2x1.5x1 cm on MRI. Since Sx will be near total glosectomy, he
was taken up for ISBT. A dose of 3.5Gy/fr/BIDx 16 fractions over 8 days was delivered. EQD2 calculated is 63Gy.
5 catheters implanted
under GA
As on May 2018 (18
months follow up)
Case 2 Dr P S Bhattacharyya/Dr C R Kundu

44. A recurrent ca. Tongue. Initially he had a 4x3x2 cm lesion in the right lateral aspect of tongue.
Underwent WLE+MRND( Jan., 2012) PT2N0M0 ,followed by adjuvant RT . At 24 months follow up
(irregular) he was detected with recurrence of 3x2x1 cm in the remnant tongue along the
previous tumor bed on MRI. He was taken up for ISBT. A dose of 4 Gy/fr/BIDx 15 fractions over 7-
8 days was delivered. EQD2 calculated was 70Gy. He was disease free for more than 3 years when
he developed a right upper GBS growth which was inoperable. Underwent Palliative
chemotherapy. Patient did not turn up after Dec., 2017.
8 catheters was
implanted
under GA
Case 3
DVH
Dr P S Bhattacharyya/Dr C R Kundu

45. Ca L angle of mouth, CT2N0M0, treated with radical
brachytherapy.3.6 Gy/fr/BID/16 fr. EQD2 65.3Gy.
5 catheters implanted
under LA.
Case 4 Dr P S Bhattacharyya/Dr V K Reddy

46. Ca soft palate T1N0M09(WDSq). MRI showed a tumor of <2x1cm thickening which
is superficial with depth not much appreciatiated. In view of the superficial invasion
she was taken up for mould brachytherapy. A dose of 3.6Gy/fr/BIDx 14 fractions over 7
days was delivered. EQD2 calculated was 57.1Gy.
Mould of the
palate
Case 5 Dr P S Bhattacharyya/Dr V K Reddy

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56. DO NOT THINK VULGAR

58. A SURGEON’S PROSPECTIVE AND DOMINANCE
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66. TESTICULAR SHIELD

67. PUT WET GAUGE
PUT WET GAUGE

68. EBRT
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Mahatma Gandhi Cancer Hospital &
Research Institute,Visakhapatnanm
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69. PENIS AND LUNGI BOTH PRESERVED

71. NO AMPUTATION PLEASE
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74. SMART THINKING
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77. Just “Doing It” is not good enough !
You must know “what” to do and “where” to do it !
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