Treatment of Complicated Cutaneous Malignant Neoplasms by Modern Radiotherapy: Principles, Practice, and Results

Farina, Anthony T.; Leider, Morris

doi:10.1111/j.1524-4725.1978.tb00543.x

Cited by 9 publications

(7 citation statements)

References 6 publications

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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%

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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%

“…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%

Radiation Therapy of Cutaneous Carcinomas: Indications in Specific Anatomic Regions

Goldschmidt¹

1991

Modern Dermatologic Radiation Therapy

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“…Legal regulations and the high start‐up cost of radiation devices discourage new installations of radiation therapy equipment in offices 7 . Simultaneously, there has been a decline in the teaching of cutaneous radiation therapy techniques in many dermatology training programs in Europe, North America, and Australia, 3,5,8 and the idea that radiation therapy should be recommended only as a “last resort” 9 is considered by younger generations of dermatologists.…”

Section: Introductionmentioning

confidence: 99%

Office‐based radiation therapy for cutaneous carcinoma: Evaluation of 710 treatments

et al. 2007

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Skin cancers are the most common malignancies and, historically, ionizing radiation has played an important role in their treatment. However, less experienced dermatologists generally consider radiation last in the line of therapeutic options. The authors sought to evaluate the effectiveness and safety of office-based elective radiation therapy for cutaneous carcinoma. A retrospective study of 604 basal cell carcinomas (BCCs) and 106 squamous cell carcinomas (SCCs) irradiated between 1971-96 was performed. The percentage of patients who developed tumor recurrence during the follow-up period was calculated using Kaplan-Meier survival curves. Cox's proportional model was used to assess the prognostic factors that might have influenced the recurrences. The recurrence rates for BCC and SCC were 11.5 and 16.5 per 1000 patient-years, respectively. The 5-year cure rates were 94.4% for BCC and 92.7% for SCC, and the 15-year cure rates were 84.8% and 78.6%, respectively. Tumor location on the nasolabial fold (OR 4.4; 95% IC, 1.3-14.7) and tumor size > or = 10 mm (OR 2.14; 95% IC, 1.03-4.45) were independent predictors of BCC recurrence. This study suggested that radiation therapy is an effective treatment for BCC and SCC and should be considered as a first option in many cases.

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“…and hence the indications (and contraindications) for radiotherapy are fairly specific (table 3). 7 Because of the disadvantages of radiotherapy (table 2), in a given situation another treatment method with a comparable cure rate and degree of cosmesis is usually used.…”

Section: Cure1tage With Electro-mentioning

confidence: 99%

Basal cell epithelioma

Browder¹,

Tomsick²

1983

Postgraduate Medicine

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Treatment of Complicated Cutaneous Malignant Neoplasms by Modern Radiotherapy: Principles, Practice, and Results

Abstract: The indispensability of modern radiotherapy for certain complicated cases of cutaneous malignant neoplasms is demonstrated by a review of its principles and demonstration of results achieved by its practice in five representative cases.

Cited by 9 publications

References 6 publications

Radiation Therapy of Cutaneous Carcinomas: Indications in Specific Anatomic Regions

Radiation Therapy of Cutaneous Carcinomas: Indications in Specific Anatomic Regions

Office‐based radiation therapy for cutaneous carcinoma: Evaluation of 710 treatments

Basal cell epithelioma

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