{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T15:08:06Z","timestamp":1770563286660,"version":"3.49.0"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,1,6]],"date-time":"2014-01-06T00:00:00Z","timestamp":1388966400000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:p>Primary peritoneal clear cell carcinoma (PP\u2010CCC), which is a rare tumor with poor prognosis, is typically managed with surgery and\/or chemotherapy. We present a unique treatment approach for a patient with a pelvic PP\u2010CCC, consisting of postchemotherapy intensity\u2010modulated radiation therapy (IMRT) followed by interstitial high\u2010dose\u2013rate (HDR) brachytherapy. A 54\u2010year\u2010old female with an inoperable pelvic\u2010supravaginal 5.6 cm T3N0M0 PP\u2010CCC tumor underwent treatment with 6 cycles of carboplatin and taxol chemotherapy. Postchemotherapy PET\/CT scan revealed a residual 3.3 cm tumor. The patient underwent CT and MR planning simulation, and was treated with 50 Gy to the primary tumor and 45 Gy to the pelvis including the pelvic lymph nodes, using IMRT to spare bowel. Subsequently, the patient was treated with an interstitial HDR brachytherapy implant, planned using both CT and MR scans. A total dose of 15 Gy in 5 Gy fractions over two days was delivered with Ir\u2010192 HDR brachytherapy. The total prescribed equivalent 2 Gy dose (EQD2) to the HDR planning target volume (PTV) from both the EBRT and HDR treatments ranged between 63 and <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/acm20202-math-0001.png\" xlink:title=\"urn:x-wiley:15269914:media:acm20202:acm20202-math-0001\"\/> due to differential dosing of the primary and pelvic targets. The patient tolerated radiotherapy well, except for mild diarrhea not requiring medication. There was no patient\u2010reported acute toxicity one month following the radiotherapy course. At four months following adjuvant radiation therapy, the patient had near complete resolution of local tumor on PET\/CT without any radiation\u2010associated toxicity. However, the patient was noted to have metastatic disease outside of the radiation field, specifically lesions in the liver and bone. This case report illustrates the feasibility of the treatment of a pelvic PP\u2010CCC with IMRT followed by interstitial HDR brachytherapy boost, which resulted in near complete local tumor response without significant morbidity.<\/jats:p><jats:p>PACS number: 87.55.\u2010x<\/jats:p>","DOI":"10.1120\/jacmp.v15i1.4520","type":"journal-article","created":{"date-parts":[[2017,2,27]],"date-time":"2017-02-27T23:21:15Z","timestamp":1488237675000},"page":"202-212","source":"Crossref","is-referenced-by-count":7,"title":["Primary peritoneal clear cell carcinoma treated with IMRT and interstitial HDR brachytherapy: a case report"],"prefix":"10.1002","volume":"15","author":[{"given":"Skyler B.","family":"Johnson","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology University of Michigan  Ann Arbor MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joann I.","family":"Prisciandaro","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Michigan  Ann Arbor MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Michigan  Ann Arbor MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott W.","family":"Hadley","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Michigan  Ann Arbor MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. 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