PENATALAKSANAAN RADIASI EKTERNA PADA KASUS SINOVIAL SARCOMA DENGAN TEKNIK VOLUMETRIC MODULATED ARC THERAPY (VMAT) DI INSTALASI RADIOTERAPI RSUD PROF. Dr. MARGONO SOEKARJO

Abstract

Research Background: Synovial sarcoma is a rare and aggressive type of soft tissue sarcoma that commonly affects adolescents and young adults. External beam radiotherapy plays an important role as an adjuvant treatment to improve local tumor control and reduce the risk of recurrence. Volumetric Modulated Arc Therapy (VMAT) enables precise radiation dose delivery to the target while minimizing radiation exposure to surrounding healthy tissues.

Objectives: This study aimed to describe the management of external beam radiotherapy using the VMAT technique for a patient with synovial sarcoma at the Radiotherapy Installation of  RSUD Prof. Dr. Margono Soekarjo.

Methods: This study used a descriptive qualitative case-study approach. Data were collected through direct observation, literature review, and documentation during the period of April 1–30, 2026. The sample consisted of one 25-year-old male patient diagnosed with left antebrachial synovial sarcoma who received a total prescribed dose of 50 Gy in 25 fractions.

Results: The radiotherapy procedure consisted of administrative preparation, radiation oncology consultation, patient positioning and immobilization, CT simulation, treatment planning using the Monaco Treatment Planning System, and treatment delivery using an Elekta Versa HD Linear Accelerator. The patient was positioned prone and immobilized using a thermoplastic mask. Cone Beam Computed Tomography (CBCT) verification was performed to ensure accurate positioning and isocenter alignment before irradiation.

Conclusions: External beam radiotherapy using VMAT provided precise dose delivery to the target while maintaining protection of surrounding healthy tissues. The combination of appropriate immobilization, CT simulation, treatment planning, and CBCT verification supported accurate and reproducible treatment delivery.