Management of advanced non‐melanoma skin cancers using helical tomotherapy

Kramkimel, N.; Dendale, R.; Bolle, Stéphanie; Zefkili, S.; Kirova, Youlia

doi:10.1111/jdv.12152

Cited by 17 publications

(6 citation statements)

References 32 publications

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“…After R1 resection, 50–60 Gy are recommended and after R2 resection, 60–70 Gy [ 2 ]. Large tumors or those in unfavorable locations can be treated by intensity-modulated radiation therapy or tomotherapy [ 50 , 51 ].…”

Section: Conventional Treatment Of Localized Bccmentioning

confidence: 99%

Usefulness of Photodynamic Therapy as a Possible Therapeutic Alternative in the Treatment of Basal Cell Carcinoma

Savoia

Deboli

Previgliano

et al. 2015

IJMS

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Basal cell carcinoma (BCC) is the most common cancer in individuals with fair skin type (I–II) and steadily increasing in incidence (70% of skin malignancy). It is locally invasive but metastasis is usually very rare, with an estimated incidence of 0.0028%–0.55%. Conventional therapy is surgery, especially for the H region of the face and infiltrative lesions; in case of inoperable tumors, radiotherapy is a valid option. Recently, topical photodynamic therapy (PDT) has become an effective treatment in the management of superficial and small nodular BCC. PDT is a minimally invasive procedure that involves the administration of a photo-sensibilizing agent followed by irradiation at a pre-defined wavelength; this determines the creation of reactive oxygen species that specifically destroy target cells. The only major side effect is pain, reported by some patients during the irradiation. The high cure rate and excellent cosmetic outcome requires considering this possibility for the management of patients with both sporadic and hereditary BCC. In this article, an extensive review of the recent literature was made, in order to clarify the role of PDT as a possible alternative therapeutic option in the treatment of BCC.

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Section: Conventional Treatment Of Localized Bccmentioning

confidence: 99%

Usefulness of Photodynamic Therapy as a Possible Therapeutic Alternative in the Treatment of Basal Cell Carcinoma

Savoia

Deboli

Previgliano

et al. 2015

IJMS

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“…Previously treated areas and organs at risks can be avoided, and simultaneous integrated boost to for example, plaque areas can be implemented. The results from this study can be of use when treating patients with partial irradiation of large areas, especially of convex shape such as the scalp or melanoma . Furthermore, this technique may be an alternative to centers where electron therapy is not available.…”

Section: Discussionmentioning

confidence: 85%

A Helical tomotherapy as a robust low‐dose treatment alternative for total skin irradiation

Haraldsson

Engleson

Bäck

et al. 2019

J Applied Clin Med Phys

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Mycosis fungoides is a disease with manifestation of the skin that has traditionally been treated with electron therapy. In this paper, we present a method of treating the entire skin with megavoltage photons using helical tomotherapy (HT), verified through a phantom study and clinical dosimetric data from our first two treated patients. A whole body phantom was fitted with a wetsuit as bolus, and scanned with computer tomography. We accounted for variations in daily setup using virtual bolus in the treatment plan optimization. Positioning robustness was tested by moving the phantom, and recalculating the dose at different positions. Patient treatments were verified with in vivo film dosimetry and dose reconstruction from daily imaging. Reconstruction of the actual delivered dose to the patients showed similar target dose as the robustness test of the phantom shifted 10 mm in all directions, indicating an appropriate approximation of the anticipated setup variation. In vivo film measurements agreed well with the calculated dose confirming the choice of both virtual and physical bolus parameters. Despite the complexity of the treatment, HT was shown to be a robust and feasible technique for total skin irradiation. We believe that this technique can provide a viable option for Tomotherapy centers without electron beam capability.

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“…RT can be delivered to fields of different sizes and with different complex shapes. Highly conformal RT, such as tomotherapy or volumetric modulated arc therapy (VMAT), allows delivery of relatively superficial RT to complex and often irregular targets, while limiting the dose to adjacent organs at risk (OARs) [9,10]. Radiation therapy can be administered via different techniques, several fractionations, and total doses.…”

Section: When Is Radiotherapy Recommended?mentioning

confidence: 99%

Radiotherapy in the Adjuvant and Advanced Setting of CSCC

Muto

Pastore

2021

Dermatol Pract Concept

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Introduction: The use of radiotherapy for cutaneous squamous cell carcinoma (CSCC) has solid historical roots. It is used with patients who are not suitable for surgery, patients with high-risk histological features in the adjuvant setting, and in palliative care. Objectives: The aim of this article is to summarize and provide a radiation therapy overview on the indications, effectiveness, and potential adverse events of radiotherapy in the adjuvant and advanced setting of CSCC. Methods: We performed a comprehensive literature review on PubMed, adopted as our biomedical literature database. Articles were selected based on their date of publication (in the last 30 years) and relevance. Results: Radiotherapy (RT) can safely be used to manage non-surgical patients and high-risk patients in the advanced CSCC setting. The remarkable progress of delivery techniques has greatly improved the effectiveness and toxicity profile of RT treatments. From 2D techniques to intensity modulated radiation therapy (IMRT), and brachytherapy, all RT techniques have greatly advanced. To improve acute and chronic side effects, deeper care has been used. As regards CSCC, several dose fractionations and schedules have been suggested, in line with the patient’s age and medical conditions. Conclusions: RT is a fundamental and constantly evolving therapeutic option in the treatment of CSCC, to minimize the risk of recurrence and metastases in the adjuvant setting and in the exclusive treatment for non-surgical patients. Patients’ selection is crucial, together with and a collaborative team working approach among the specialists involved in disease management in the perspective of the best multidisciplinary assessment.

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Management of advanced non‐melanoma skin cancers using helical tomotherapy

Abstract: HT is an effective option for advanced non-melanoma skin cancers as radical treatment or in association with surgery. Early and late toxicity and cosmetic results are acceptable.

Cited by 17 publications

References 32 publications

Usefulness of Photodynamic Therapy as a Possible Therapeutic Alternative in the Treatment of Basal Cell Carcinoma

Usefulness of Photodynamic Therapy as a Possible Therapeutic Alternative in the Treatment of Basal Cell Carcinoma

A Helical tomotherapy as a robust low‐dose treatment alternative for total skin irradiation

Radiotherapy in the Adjuvant and Advanced Setting of CSCC

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