BACKGROUND: We present the clinical course of a pediatric @entity1 with large @entity980 of the body trunk who received @entity34 ( @entity34 ). CASE PRESENTATION: A 1-year-old @entity1 was diagnosed with stage IV @entity3943 in 2008. A large @entity5 was located in the central diaphragm and had infiltrated the liver and pericardium with peritoneal dissemination. Chemotherapy was immediately started with six courses of @entity1891 , @entity4316 and @entity786 (VAC) firstly, and secondly followed by 2 courses of @entity1260 , @entity3003 and @entity2879 (ICE), but a large @entity5 of 15  cm in size remained. The @entity5 was inoperable because of its location, and photon radiotherapy could not be performed due to limited liver tolerance. The @entity1 was referred to our hospital and received @entity34 at a dose of 54 GyE in 30 fractions in June 2009. The @entity5 quickly responded and 95  % of volume reduction was achieved at the end of @entity34 . However, marginal recurrence in the caudal part of the irradiated field, where we reduced the proton dose because of the presence of the intestine, was detected in August 2010. The recurrent @entity5 size was less than 1  cm. Chemotherapy with VAC followed by @entity1945 and @entity3003 (TC) was again tried, but the @entity5 size was stable. Repeated @entity34 was not possible because of limited intestinal tolerance; therefore, intraoperative radiotherapy was conducted with 20  Gy of electron beams in April 2011. The @entity5 was subsequently well controlled, but secondary @entity2590 developed and the @entity1 died of @entity9058 after umbilical cord blood transplantation in May 2012. CONCLUSION: @entity34 was performed safely and effectively for a 1-year-old @entity1 with @entity3943 with liver and cardiac invasion that was resistant to surgery and chemotherapy. This case illustrates that @entity34 can be useful in cases that are difficult to treat with conventional radiotherapy.

Proton beam therapy for a XXXX with large @entity980 of the body trunk.

@entity1 :: ('9606', 'Species') :: ['girl', 'patient'] @entity9058 :: ('MESH:D051359', 'Disease') :: ['hemophagocytic syndrome'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity3003 :: ('MESH:D016190', 'Chemical') :: ['carboplatin'] @entity786 :: ('MESH:D003520', 'Chemical') :: ['cyclophosphamide'] @entity2590 :: ('MESH:D009190', 'Disease') :: ['myelodysplastic syndrome'] @entity4316 :: ('MESH:D003609', 'Chemical') :: ['actinomycin-D'] @entity2879 :: ('MESH:D005047', 'Chemical') :: ['etoposide'] @entity1891 :: ('MESH:D014750', 'Chemical') :: ['vincristine'] @entity1260 :: ('MESH:D007069', 'Chemical') :: ['ifosfamide'] @entity980 :: ('MESH:D012208', 'Disease') :: ['rhabdomyosarcoma'] @entity3943 :: ('MESH:D018232', 'Disease') :: ['alveolar rhabdomyosarcoma'] @entity1945 :: ('MESH:D019772', 'Chemical') :: ['topotecan'] @entity34 :: ('MESH:D016609', 'Disease') :: ['proton beam therapy', 'PBT']
@entity1 :: (9606,Species) :: ['patient']
