| Patient Information: (Do not provide name of the patient) |
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Age
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87
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Diagnosis
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recurrent penile SCC (if ok to do non-prostate GU)
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Imaging
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Multiple right inguinal necrotic masses are increased in size. For instance on series 3 image 140, a node measures 6.5 x 4.6 cm, previously 5.6 x 4.1 cm. Immediately superiorly, there is a necrotic node measuring 3.7 x 2.9 cm (series 3 image 108), previously 3.2 x 2.2 cm. Multiple additional nodes are slightly increased in size. Slightly increased left inguinal lymph node measuring 3.7 x 2.1 cm (series 3 image 499), previously 3.5 x 2.0 cm. Right iliac chain node measuring 1.6 cm (series 3 image 398), unchanged. No suspicious retroperitoneal or mesenteric lymphadenopathy.
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Pathology
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LN: Metastatic squamous cell carcinoma (High PD-L1 Exp)
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Stage
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pT2; recurrent cN3, cM0
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| Overall Oncology Management Plan |
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Surgery (biopsy)
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4/1/2021 partial penectomy; for LN recurrence discussed debulking LND- none planned
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Chemotherapy (if given, what is the regimen)
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no (ECOG PS)
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Hormone Therapy
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no
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Radiation Therapy (fields, dose)
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inguinal and pelvic LN
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| Radiation Treatment Plan |
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Defining target and margin
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enlarged LN- "GTV/CTV/PTV 6500", non-enlarged, inguinal, obturator, int and ext iliacs "CTV/PTV 5000"
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Treatment fields review
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inguinal, obturator, int and ext iliacs, top boarder at L5/S1/common iliac bif
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DVH
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red- PTV 6500/ PTV eval; blue- PTV 5000; yellew/brown- bladder/rectum, yellow- ext genitalia; pink- bowel bag
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Dose/fractionation
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5000 cGy in 25 fractions to nonenlarged lymph nodes with 6250–6500 cGy to grossly involved lymph nodes delivered by SIB in 25 fractions.
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| Images |
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Upload Image
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Session Name
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Prostate Specialist Ronald Chen – 11/11/21
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Session ID
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10659
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created_by
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7295
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post_id
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10659
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