title: Pediatric peri-operative fractionated high-dose-rate brachytherapy for recurrent Wilms' tumor using a reconstructed Freiburg flap.
abstract: OBJECTIVE
  To report peri-operative fractionated high-dose-rate (HDR) brachytherapy with a 3D customized Freiburg flap applicator to treat locally recurrent Wilms' tumor, followed by immediate hyperthermic intraperitoneal chemotherapy for a 16-year-old with a second recurrence of nephroblastoma (Wilms' tumor).
  
  
  METHODS
  The tumor was excised and surgical bed was treated with fractionated HDR brachytherapy using a Freiburg flap applicator. Hyperthermic intraperitoneal chemotherapy was performed immediately after the removal of brachytherapy applicator.
  
  
  RESULTS
  The Freiburg flap was successfully reconstructed to enable delivery of conformable peri-operative HDR brachytherapy. The clinical target volume (CTV) D90was 26 Gy in 5 fractions.
  
  
  CONCLUSIONS
  Peri-operative fractionated HDR brachytherapy with a customized Freiburg flap applicator was delivered successfully across a large multi-disciplinary team.
authors.affiliation: Crown Princess Mary Cancer Centre, Westmead; Institute of Medical Physics, University of Sydney, Camperdown.
authors.forename: Emily
authors.initials: E
authors.lastname: Flower
authors.affiliation: Crown Princess Mary Cancer Centre, Westmead.
authors.forename: Kathy Ngoc
authors.initials: KN
authors.lastname: Tran
authors.affiliation: Crown Princess Mary Cancer Centre, Westmead.
authors.forename: Salman
authors.initials: S
authors.lastname: Zanjani
authors.affiliation: Crown Princess Mary Cancer Centre, Westmead.
authors.forename: Wayne
authors.initials: W
authors.lastname: Smith
authors.affiliation: Pediatric Surgery Children's Hospital at Westmead, Westmead; Discipline of Pediatrics & Child Health, Sydney Medical School, University of Sydney, New South Wales, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Karpelowsky
authors.affiliation: Crown Princess Mary Cancer Centre, Westmead.
authors.forename: Katie
authors.initials: K
authors.lastname: Summerhayes
authors.affiliation: Crown Princess Mary Cancer Centre, Westmead.
authors.forename: Edgar
authors.initials: E
authors.lastname: Estoesta
authors.affiliation: Crown Princess Mary Cancer Centre, Westmead.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Chard
keywords: Wilms tumor; nephroblastoma; pediatric brachytherapy; peri-operative