Modern radiotherapy for malignant epitheliomas

Farina, Anthony T.

doi:10.1001/archderm.113.5.650

Cited by 6 publications

(5 citation statements)

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“…Special consideration is required in the area of the canthi, especially for lesions involving the inner canthus (Color Figs. [13][14][15][16][17][18], where carcinomas often extend deeper than clinically suspected. Large field sizes and selection of a more penetrating X-ray beam are necessary in this area.…”

Section: Location Of Tumormentioning

confidence: 99%

“…For tumors involving the inner or outer canthi, both eyelids have to be exposed and brass, lead, or gold eye cups are preferred (Figs. 14,15,19) Tongue-Shaped Eye Shields. These shields were originally made of lead, 0.92 mm in thickness.…”

Section: Dosementioning

confidence: 99%

“…Formerly available commercial eye shields were made of silver-plated lead (Gugelman), brass, or gold.12 G l a d~t e i n~~ has recently designed a practical lead and bismuth eye shield with a handle at the end rather than in the center (Figs. 14,19). This cup is easier to insert and to remove than older shield types, and the handle does not interfere with overlay shielding.…”

Section: Dosementioning

confidence: 99%

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Radiation Therapy of Cutaneous Carcinomas: Indications in Specific Anatomic Regions

Goldschmidt¹

1991

Modern Dermatologic Radiation Therapy

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Cutaneous carcinomas involving the nose and perinasal area are common; statistics from a large group of patients indicate that 20-25% of all facial cutaneous carcinomas occur in this anatomic region.' Several therapeutic modalities can be used effectively for these cancers. In our experience, the cosmetic and functional improvements following X-ray therapy of certain cancers of the nose are among the most gratifying results of dermatologic radiotherapy.Most dermatologists have seen poor cosmetic results after simple excision with primary side-to-side closure because this method may bring about asymmetrical changes in the overall contour of the nose. Curettage and electrodesiccation may also yield unsatisfactory results because the nose has a stronger tendency to develop unsightly depressed scars than other facial regions. Dermatologists who are aware of these therapeutic problems often refer patients with large cancers of the nose to plastic surgeons or to specially trained dermatologic surgeons for more extensive surgical procedures, including flaps, skin grafts, cryosurgery, or chemosurgery. There is no doubt that these procedures can yield excellent results in skilled hands. However, in a good number of patients with medium-sized tumors, radiotherapy offers a valuable alternative which should be considered, and discussed with the patient, before extensive surgical procedures are contemplated. Radiotherapy is especially useful in patients with medical problems that could interfere with surgery, in patients who refuse surgery, and in patients whose carcinomas have recurred following surgical treatment.Reprints are not available ARTICLE Compared with complicated surgical techniques, radiotherapy is relatively easy to administer and is not associated with any major discomfort during or after treatment. Patients do not require hospitalization or anesthesia, nor do they require sophisticated reconstructive procedures. Cosmetic results are often excellent, primarily because radiotherapy does not change the contour of the treated area and it preserves the normal surrounding Surgery often requires the removal of fairly large lateral and deep margins which can preclude a good cosmetic result.6 In radiotherapy the uninvolved margin can be as large as desired without significant cosmetic consequences; since carcinomas are more radiosensitive than normal tissue, only the tumor itself is eliminated and not the normal surrounding skin. Cosmetically disturbing radiation sequelae are uncommon in this anatomic region when proper radiation techniques are used. This was not the case several decades ago when carcinomas of the skin overlying nasal cartilages were treated with high doses of poorly fractionated and unnecessarily penetrating X rays. These obsolete radiation techniques sometimes resulted in painful chondritis or chondronecrosis and other undesirable sequelae. Modern radiotherapy with relatively soft X rays delivered in properly fractionated doses has reduced these problems to a minimum. Indications for Radiotherapy TYP...

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Section: Location Of Tumormentioning

confidence: 99%

Section: Dosementioning

confidence: 99%

Section: Dosementioning

confidence: 99%

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Radiation Therapy of Cutaneous Carcinomas: Indications in Specific Anatomic Regions

Goldschmidt¹

1991

Modern Dermatologic Radiation Therapy

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“…These machines have no place in the treatment of most cutaneous cancers because of their great penetration ( D 1/2 50–80 mm); they may be valuable for treatment of rare cancers that involve bones or lymph nodes or for cancers with other unusual complications 48–50 …”

Section: Radiation Techniquesmentioning

confidence: 99%

Office Radiotherapy of Cutaneous Carcinomas

Goldschmidt¹,

Sherwin²

1983

The Journal of Dermatologic Surgery and Oncology

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“…Tumors larger than 3 cm in diameter and carcinomas with deep involvement of cartilage or bone are not suitable for office radiotherapy. They should be referred to radiation oncology departments when surgical treatments are not feasible 14,15 . This also applies to tumors extending from the lip into the nasal orifice and to carcinomas involving the septum nasi which often show early deep infiltration.…”

Section: Carcinoma Of the Nosementioning

confidence: 99%