Salvadó Jassans, JosepPla general de l'obra: A Lluís Millet. Es veu la figura, en bronze,
 del músic i fundador de l'Orfeó Català, en el gest de dirigir. 
Està situada a l'exterior del Palau de la Música Catalana

Rodriguez Rodriguez, I.

Asencio Duran, M.

Manzano Muñoz, B.

Escribano Uzcudum, A.

Corredoira, E.

Huerga, C.

Mañas Rueda, A.

I. Rodriguez Rodriguez

M. Asencio Duran

B. Manzano Muñoz

A. Escribano Uzcudum

E. Corredoira

C. Huerga

A. Mañas Rueda

Crossref

Reports of Practical Oncology & Radiotherapy

Accurate placement of epiescleral plaque in brachytherapy of choroideal melanoma

Salvadó Jassans, JosepPrimer pla de l'edifici nou del Palau de la Música Catalana. Es situa l'obra, A Lluís Millet, en bronze,
 del músic i fundador de l'Orfeó Català, en el gest de dirigir

Universitat de Barcelona. Centre de Recerca Polis

Direcció Tècnica d'Urbanisme

Repositori Obert de Coneixement de l'Ajuntament de Barcelona

A Lluís Millet

Salvadó Jassans, JosepPla mig de l'obra: A Lluís Millet. Es veu la figura, en bronze,
 del músic i fundador de l'Orfeó Català, en el gest de dirigir. 
Està situada a l'exterior del Palau de la Música Catalana

Elsevier - Publisher Connector 

reports of practical oncology and radiotherapy 1 8 ( 2 0 1 3 ) S122–S125
Available online at www.sciencedirect.com
journa l homepage: ht tp : / /www.e lsev ier .com/ locate / rpor
Brachytherapy
Accurate placement of epiescleral plaque in brachytherapy of choroideal melanoma
I. Rodriguez Rodriguez1, M. Asencio Duran2, B. Manzano Mun˜oz2, A. Escribano Uzcudum1, E. Corredoira3,
C. Huerga3, A. Man˜as Rueda1
1 Hospital Universitario La Paz, Oncologia Radioterápica, Spain
2 Hospital Universitario La Paz, Oftalmología, Spain
3 Hospital Universitario La Paz, Radiofísica, Spain
Purpose/Objective. Present a case showing a technique for accurate plaque placement in episcleral brachytherapy of choroidal
melanoma.
Materials and methods. The diagnosis of choroidal melanoma is based on the results of ophthalmoscopic and ultrasonographic
examination and completed with metastatic workup. For dosimetric purposes, a virtual simulator of the eyeball is used for
extrapolation of ultrasound and fundoscopy imaging to determine the clinical target volume (CTV) which includes a minimum
margin of 2mm around the tumor. Prescribed dose to the apex of the tumor is 85Gy. Intraoperative trans-scleral illumination
is done in the opposite side of the tumor and the tumor shade (tumor margin) is marked on the scleral surface with a surgical
marker. A dummy plaque is temporally sutured to the sclera exactly in the place of the gross tumor volume (GTV). The perimeter
of the plaque can be observed by reﬂecting the inner surface of the plaque during indirect ophthalmoscopy as a circle of light
surrounding the tumor. This makes it possible to determine the exact position of the entire plaque in relation to GTV. If necessary,
intraoperative ultrasound B-scan can be used to verify plaque location. Once the correct position is found, the dummy plaque
is replaced by a radioactive plaque and sutured deﬁnitively. The operated eye is patched and the patient remains hospitalized
until plaque removal.
Results. This technique facilitates the identiﬁcation of the local gross tumor volume and allows an accurate positioning of the
plaque in direct contact with the tumor choroid melanoma. The selection of an adequate size of plaque is also critical.
Conclusions. Precise plaque localization is critical to ensure that the choroidal tumor receives the dose prescribed. The team’s
experience is highly relevant for successful performance of this technique and achieving a signiﬁcant learning curve for plaque
placement technique remains a challenge.
http://dx.doi.org/10.1016/j.rpor.2013.03.659
Demostration video brachytherapy implant high rate of plastic tubes in cancer soft palate
E. Martinez, V. Garcia, E. Cardenas, A. Lozano, R. Garcia
Hospital Universitario Virgen De La Arrixaca, Spain
Summary. Our video shows the process of implantation of plastic tubes from the ﬁrst visit in consultation of a 56-year-old male
patient diagnosed with squamous cell carcinoma of cT2 cN2a Mo soft palate (history, examination, and images) CT simulation,
contouring, planned and treatment until the withdrawal out of the tubes. External radiation therapy 44Gy photons bilateral
neck, bilateral clavicular 50Gy, ipsilateral neck with electrons up to 56Gy, and 56Gy bilateral anterior neck, and N (+) to 70Gy,
cisplatin at 40mg/m2/week was changed to cetuximab for thrombocytopenia. Has presented mucositis and xerostomia G2.
Subsequently, he has been treated with interstitial brachytherapy boost. The implementation of the tubes is carried under
general anesthetic in the operating theater CMF central through Pernot technique. The postoperative course was uneventful.
CT is performed, contouring, marking the area of 70Gy in neck ﬁve fractions to 3 gy were applied separated by at least 6h
Total 15Gy to PTVt with DBE a/b 2=18 and 74Gy total dose tumor. A week presented mucositis G2 geographical marking the
1507-1367/$ – see front matter


Accurate placement of epiescleral plaque in brachytherapy of choroideal melanoma 

file:///data/core-remote/dit/data/elsevier/pdf/612/aHR0cDovL2FwaS5lbHNldmllci5jb20vY29udGVudC9hcnRpY2xlL3BpaS9zMTUwNzEzNjcxMzAwNzA2Mg==.pdf

Accurate placement of epiescleral plaque in brachytherapy of choroideal melanoma

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