LATTICE Radiotherapy with RapidArc for Treatment of Gynecological Tumors:Dosimetric and Early Clinical Evaluations

Background: We report the case of a patient with an advanced carcinoma of the cervix treated using the new concept of LATTICE Radiotherapy (LRT). We describe the dose distribution, planning and delivery of treatment as well as the clinical evaluation of the patient during and at the completion of treatment. The basic principle of LATTICE is to create, within the tumor volume, multiple localized high-dose islands with a certain degree of separation to form lower dose regions. Methods: This is case report based on a 48-year-old female, G1P1, who presented with advanced cervical carcinoma and a bulky pelvic mass. The patient was treated with Trilogy equipment using IMRT. She received two fractions of 3 Gy each to the pelvis, on an emergent basis, using conventional 3-D conformal irradiation. Following this course, she was treated with LATTICE radiotherapy (LRT) in order to create a non-homogeneous dose distribution analogous to interstitial brachytherapy, combined with conventional IMRT. Results: The patient underwent TAH/BSO six weeks post-LATTICE and there was complete clinical pathological response. She continues with maintenance chemotherapy, and at this time the patient is NED. Conclusions: LATTICE Radiotherapy (LRT) using Rapid Arc appears to be a safe and effective approach for the treatment of bulky gynecological tumors. Further prospective clinical trials need to be developed in order to test this hypothesis.