BMC Research Notes | |
An electronic brachytherapy technique for treating squamous cell carcinoma in situ of the digit: a case report | |
Alice C Watson1  V Elayne Arterbery2  | |
[1] Department of Dermatology, University Physician Group-Georgetown, Professional Building, Suite 208, Sterling Heights, MI, 48310, USA;Crittenton Radiation Oncology Center, 1901 Star Batt Drive, Rochester Hills, MI, 48309, USA | |
关键词: Electronic brachytherapy; Radiation therapy; Skin cancer; | |
Others : 1142937 DOI : 10.1186/1756-0500-6-147 |
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received in 2012-08-14, accepted in 2013-02-27, 发布年份 2013 | |
【 摘 要 】
Background
Squamous cell carcinoma in situ of the digit presents a complex management problem, which is usually treated with surgery or radiation or topical agents. The outcome of the surgical treatment can be an undesirable cosmetic result and loss of function. We report a unique Electronic Brachytherapy technique to treat the digit, which uses a 50 Kv miniaturized X-ray source with specialized applicators.
Case presentation
A 62-year-old African-American male was presented with a 12-month history of gradual darkening of the dorsal-distal middle left finger. Examination revealed a hyper pigmented scaly patch on the proximal to lateral nail fold of the L 3rd finger, nail dystrophy, and vertical split in the lateral section of the nail. The patient underwent evaluation of the lesion by Plastic Surgery with the removal of the lateral nail and a nail bed biopsy. Pathology revealed squamous cell carcinoma in situ with a possible focal positive, deep margin. The patient deliberated over surgical opinions, and eventually decided on radiation. A high dose rate Electronic Brachytherapy system using the XOFT Accent controller delivered dose of 4000 cGy in eight fractions, twice weekly, with at least 48 hours between fractions and treatment prescribed to a depth of 0 to 2 mm. The Xoft unit has specialized skin applicators that permit superficial treatment. Parameters assessed included the efficacy, cosmetic results feasibility, and acute safety of the Electronic Brachytherapy technique.
Conclusions
The patient exhibited moderate redness, hyperpigmentation erythema, desquamation, and Grade 1 to 2 edema acutely (following radiation), which resolved within 1 month of the treatment. Electronic brachytherapy treatment delivery took about 6 minutes, and the total procedure time was about 15 minutes. At the median follow-up of one year, the area revealed excellent cosmesis, and there was no infection or fat necrosis, desquamation, no cancer recurrence, and no evidence of fibrosis at the last follow-up. This suggests that Electronic Brachytherapy was a viable treatment option for this particular patient.
【 授权许可】
2013 Arterbery and Watson; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20150328191606858.pdf | 2691KB | download | |
Figure 4. | 76KB | Image | download |
Figure 3. | 80KB | Image | download |
Figure 2. | 138KB | Image | download |
Figure 1. | 117KB | Image | download |
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