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Dermatology
Radiotherapy
Built from Dermatology, 5th Edition
What’s inside
10 sections · 78 slides
Overview
- Six things this topic covers
Basics of Radiotherapy
What radiotherapy is, how it kills cancer cells, and the machines that deliver it
- What radiotherapy treats in dermatology
- Three goals of radiotherapy
- Three intents behind every radiotherapy plan
- How X-rays kill cancer cells
- The chain from X-ray to a dead cancer cell
- Treatment machines
- Units and fractions
- Choosing a dose: fractionation
- Suggested dose fractionation schedules for basal cell carcinomas (BCCs) and cutaneous squamous cell carcinomas (SCCs)
- Low-energy photon beams: superficial and orthovoltage
- Electron beam therapy
- Electron beam depth-dose curve
- Depth dose of electron beams, with and without a bolus
- Brachytherapy: radiotherapy from inside
- Two forms of skin brachytherapy
- Radiotherapy modalities and physical and technical parameters
- Advantages of radiotherapy
- Disadvantages and risks of radiotherapy
- Who should avoid radiotherapy
Radiotherapy of Benign Skin Disorders
Radiotherapy for keloids and a rare inflammatory mimic of lymphoma, after riskier historical uses were dropped
- A shrinking role in benign disease
- Keloids: preventing regrowth after surgery
- Cutaneous pseudolymphoma
Radiotherapy of In Situ Cutaneous Malignancies
Treating cancer that has not yet invaded past the skin's surface layer
- Squamous cell carcinoma in situ (Bowen disease)
- Lentigo maligna
- Lentigo maligna before and after radiotherapy
Basal Cell Carcinoma
Definitive and adjuvant radiotherapy for BCC, and when it beats surgery
- Definitive radiotherapy for BCC
- Patient factors and tumor characteristics that favor radiotherapy
- Superficial BCC treated with definitive radiotherapy
- Nodular BCC of the medial canthus: before, marked, and after radiotherapy
- Extensive BCC of the temple before and after superficial radiotherapy
- Nodular BCC of the ala nasi before and after radiotherapy
- Adjuvant radiotherapy after incomplete BCC excision
Squamous Cell Carcinoma
Risk features, definitive and adjuvant radiotherapy, and special situations like the lip and nerve invasion
- High-risk features of cutaneous SCC
- Definitive radiotherapy for SCC
- Adjuvant radiotherapy for SCC
- Keratoacanthoma
- Squamous cell carcinoma of the lip
- Squamous cell carcinoma of the lip before and after definitive radiotherapy
- Lymph node metastases from SCC
- Perineural invasion
- SCC and BCC in immunosuppressed patients
- Choosing the dose and treatment field
Merkel Cell Carcinoma, Sarcomas, and Lymphomas
Radiotherapy for rarer but more aggressive skin cancers
- Merkel cell carcinoma: an aggressive skin cancer
- Merkel cell carcinoma treated with wide-field radiotherapy
- Radiotherapy for Merkel cell carcinoma
- Angiosarcoma
- Kaposi sarcoma
- Cutaneous lymphomas
- Total skin electron beam therapy (TSEBT)
- How a course of TSEBT is delivered
- Adnexal carcinomas
Palliation
Using radiotherapy to ease symptoms when a cure is no longer possible
- Palliating advanced, incurable tumors
- Palliating metastases
- Metastatic SCC of the parotid lymph nodes before and after palliative radiotherapy
Reactions and Complications
Acute skin reactions, late tissue effects, and how each is managed
- Acute radiodermatitis
- Radiotherapy reactions and complications
- Radiotherapy reactions and complications (continued)
- Treatment of acute radiodermatitis
- Radiation recall and enhancement
- Late effects of radiotherapy
- Acute and chronic cutaneous side effects of radiation therapy
- Treating younger patients
- Skin diseases that radiotherapy can trigger
- Diseases induced by radiation therapy
- Diseases induced by radiation therapy (continued)
- Further examples of acute and chronic radiation-induced skin reactions
Future Trends
Sharper imaging and more precise dose shaping are reshaping how radiotherapy is planned
- Future trends in radiotherapy
- Key takeaways
- References
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- References (continued)
- Dermatology, 5th Edition (2-Volume Set)