title: Whole abdominopelvic radiotherapy in the palliative treatment of pseudomyxoma peritonei.
abstract: BACKGROUND
  Pseudomyxoma peritonei (PMP) is a rare clinical syndrome characterized by mucinous peritoneal disease arising from disseminated peritoneal adenomucinosis. Primary treatment involves a combination of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC). There is no consensus on the proper treatment of recurrent PMP. In selected patients, repeated cytoreductive surgery with or without HIPEC might improve outcome. However, every repeated debulking procedure becomes less effective with increased morbidity.
  
  
  METHODS
  We present a case of a patient with intestinal obstruction caused by recurrent pseudomyxoma peritonei. We treated the patient with whole abdominopelvic radiotherapy (WAPRT) using intensity-modulated arc therapy (IMAT) to a total dose of 33 Gy, delivered in 22 daily fractions. The treatment was well tolerated and resulted in resolution of the obstruction for a period of 24 months.
  
  
  CONCLUSIONS
  To the best of our knowledge, we present the first case report showing the possibility of resolving intestinal obstruction with WAPRT in a patient with recurrent PMP. It is our opinion that WAPRT delivered by IMAT, in analogy with ovarian cancer, should be considered as a palliative treatment option in managing patients with recurrent PMP especially in case of obstruction.
authors.affiliation: Department of Radiotherapy, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium, Patrick.Berkovic@uzgent.be.
authors.forename: P
authors.initials: P
authors.lastname: Berkovic
authors.forename: L
authors.initials: L
authors.lastname: van de Voorde
authors.forename: G
authors.initials: G
authors.lastname: De Meerleer
authors.forename: L
authors.initials: L
authors.lastname: Delrue
authors.forename: B
authors.initials: B
authors.lastname: Speleers
authors.forename: S
authors.initials: S
authors.lastname: Van Belle
authors.forename: K
authors.initials: K
authors.lastname: Vandecasteele
mesh_terms: D000005:Abdomen / Q000528:radiation effects; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000532:radiotherapy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D010166:Palliative Care / Q000379:methods*; D010388:Pelvis / Q000528:radiation effects; D010534:Peritoneal Neoplasms / Q000532:radiotherapy*; D011553:Pseudomyxoma Peritonei / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D014057:Tomography, X-Ray Computed