Photon Radiation Therapy for Skin Malignancies is a vital resource for dermatologists interested in radiation therapy, including the physics and biology behind treatment of skin cancers, as well as useful and pragmatic formulas and algorithms for evaluating and treating them. Dermatology has always been a field that overlaps multiple medical specialties and this book is no exception, with its focus on both dermatologists and radiation oncologists. It is estimated that between 2010 and 2020, the demand for radiation therapy will exceed the number of radiation oncologists practicing in the U.S. tenfold, which could profoundly affect the ability to provide patients with sufficient access to treatment. Photon Radiation Therapy for Skin Malignancies enhances the knowledge of dermatologists and radiation oncologists and presents them with the most up-to-date information regarding detection, delineation and depth determination of skin cancers, and appropriate biopsy techniques. In addition, the book also addresses radiation therapy of the skin and the skin’s reactions to radiation therapy.
Author(s): Armand B Cognetta, William M. Mendenhall
Edition: 2013
Publisher: Springer
Year: 2013
Language: English
Pages: 250
Tags: Медицинские дисциплины;Клинические методы диагностики, лабораторная диагностика;Лучевая диагностика и терапия;
Preface......Page 8
Contents......Page 10
Contributors......Page 12
History of Radiation Therapy in Dermatology......Page 14
References......Page 19
Interaction of Radiation with Matter......Page 21
Interaction Types......Page 22
Linear Energy Transfer......Page 23
Relative Biological Effectiveness......Page 24
Cell Survival Curves......Page 25
Oxygen Effect......Page 26
Fractionation......Page 27
References......Page 28
Electromagnetic Spectrum......Page 29
Nonionizing vs. Ionizing in Electromagnetic Spectrum......Page 30
X-ray Production......Page 31
Bremsstrahlung X-rays......Page 33
X-ray Beam Quality and Filtration......Page 35
Kilovolt Peak......Page 36
Milliamperage (MA)......Page 37
Percentage Depth Dose (Depth Dose)......Page 38
D ½ vs. D90 Philosophy......Page 40
Radiation Exposure......Page 42
Electronic Equilibrium (Dmax)......Page 43
Superficial Therapy......Page 44
Brachytherapy......Page 45
Electron Beams......Page 46
References......Page 47
Radiation Protection......Page 48
Calibration......Page 53
Record Keeping......Page 54
References......Page 55
Introduction......Page 56
Squamous Cell Carcinoma and Basal Cell Carcinoma of the Skin......Page 57
Staging for Squamous Cell Carcinoma Treated by Dermatologists Utilizing Radiotherapy......Page 60
Clinical Examples for Staging SCC and BCC in Dermatologic Radiotherapy......Page 61
Half-Value Depth (D ½ Philosophy) and Depth Assessment......Page 62
References......Page 64
Introduction......Page 66
Risk Factors......Page 67
Pathophysiology......Page 68
Assessment of Radiodermatitis......Page 69
Management of Acute Radiodermatitis......Page 71
Topical Corticosteroids......Page 72
Other Topical Products......Page 73
Pentoxifylline......Page 74
Conclusion......Page 75
References......Page 76
Efficacy for Primary BCC and SCC......Page 81
Cosmesis......Page 83
Comparison to Electron Beam Radiotherapy......Page 85
Conclusion......Page 87
References......Page 88
Introduction......Page 90
Overview of Superficial Radiotherapy......Page 91
General Indications for Superficial Radiotherapy of BCC/SCC......Page 92
Considerations for Surgery of BCC/SCC......Page 94
References......Page 95
Therapeutic Index......Page 98
Time, Dose, and Fractionation......Page 99
The Effect of Dose......Page 100
The Nominal Standard Dose......Page 101
The Time Dose Fractionation Factor......Page 102
Tumor Depth......Page 108
Half-Value Depth (D ½)......Page 109
Umbra Selection......Page 110
Dose and Fractionation Schemes......Page 111
Patient Evaluation for Superficial Radiation Therapy......Page 112
Indications......Page 113
Radiation Positioning and Shielding......Page 114
Shielding......Page 115
Select Depth of Penetration......Page 124
Select Umbra, Shields, and Cone Size......Page 125
Patient Eligibility......Page 126
Prescription and Fractionation Log......Page 128
Accounting for Treatment Interruptions......Page 129
Example of a Decay Event......Page 131
Example of a Second Check Calculation......Page 132
Weekly Management of Patient’s Dose Response......Page 133
References......Page 135
Introduction......Page 136
Safety Issues/Radiogenic Carcinomas......Page 138
Licensing Regulations and Maintenance......Page 139
Start-up Costs......Page 140
Lack of Teaching on the Practical Application and Use of Superficial Radiotherapy......Page 141
Cost Analysis of RT in Dermatology Setting Versus Radiation Oncology Setting and Mohs Surgery......Page 142
References......Page 144
Physical Characteristics of Grenz Ray......Page 146
Other Physical Properties......Page 147
Calibration......Page 148
Physical Effects of Grenz Ray......Page 149
Grenz Ray for Lentigo Maligna......Page 150
Grenz Ray for Bowen’s Disease......Page 153
Grenz Ray for Actinic Keratosis......Page 155
Grenz Ray for Inflammatory Skin Diseases......Page 156
References......Page 160
Staging......Page 163
Radiotherapy Alone......Page 165
Management of Regional Lymph Node Metastases......Page 166
Treatment Techniques......Page 167
Results......Page 169
Regional Nodes......Page 172
References......Page 173
Introduction......Page 175
Historical Use in Dermatology......Page 176
Technical Aspects......Page 179
Radiation Source and Dose Delivery......Page 180
Surface-Mold Brachytherapy......Page 181
Interstitial Brachytherapy......Page 185
Efficacy and Indications......Page 186
Tolerability, Cosmesis, and Adverse Events......Page 187
References......Page 189
Introduction......Page 191
Treatment Outcomes......Page 192
References......Page 195
Introduction......Page 197
Histopathology......Page 198
Staging......Page 199
Outcomes......Page 200
Chemotherapy......Page 201
References......Page 202
Introduction......Page 204
Diagnostic Evaluation......Page 205
Outcomes......Page 206
References......Page 209
Introduction......Page 212
Primary Cutaneous Follicular Center Lymphoma......Page 213
Primary Cutaneous Diffuse Large B-Cell Lymphoma-Leg Types......Page 214
Primary Cutaneous T-Cell Lymphoma......Page 215
Total Skin Electron Beam Treatment......Page 218
References......Page 219
Introduction......Page 221
Treatment......Page 222
Outcomes......Page 224
References......Page 227
Introduction......Page 230
Incidence of Positive Sentinel Lymph Node Biopsy......Page 231
Incidence of Residual Positive Nodes in a Completion Node Dissection After a Positive SLNB......Page 232
Adjuvant Radiotherapy......Page 233
References......Page 237
Introduction......Page 240
Planning......Page 241
Implementation......Page 244
Index......Page 246
