Hand function after high dose rate brachytherapy for squamous cell carcinoma of the skin of the hand.

2.50
Hdl Handle:
http://hdl.handle.net/10541/67985
Title:
Hand function after high dose rate brachytherapy for squamous cell carcinoma of the skin of the hand.
Authors:
Somanchi, B V; Stanton, Anthony; Webb, M; Loncaster, Juliette A; Allan, Ernest; Muir, L T S W
Abstract:
AIMS: Current recommendations for the treatment of squamous cell carcinoma of the hand are almost unanimously in favour of ablative surgery. However, many of the patients are frail and elderly, and surgical techniques frequently involve skin grafts or amputation of digits. A non-invasive method of treatment is, therefore, often preferred. Radiotherapy using a brachytherapy technique is a well-established option. This study investigated whether patients found the treatment acceptable and assessed the outcome of treatment in terms of local control, cosmesis and hand function. MATERIALS AND METHODS: Twenty-five patients who underwent mould brachytherapy using a microselectron high dose rate radiotherapy device were available for assessment. We assessed the functional status of the hand and fingers by means of the Disability of Arm, Shoulder and Hand and Michigan Hand Outcomes questionnaires. We examined the hand to assess the severity of post-radiation stigmata. We enquired as to patient acceptability of treatment and outcome. RESULTS: Of 25 patients who agreed to participate, the fingers were affected in 15 and the dorsum of the hand in 10. The mean age at the time of radiotherapy was 69 years (range 50-87). There were no significant differences in parameters, such as range of motion of fingers and wrist, hand/finger grip strength, between the treated and opposite sides. Sensation, including two-point discrimination, was not significantly different from the untreated hand. Seventeen patients had minor skin changes. No patient found the treatment painful or unacceptable. Twenty patients were very satisfied and five patients were moderately satisfied with the cosmetic result. CONCLUSIONS: We conclude that high dose rate brachytherapy is a safe and simple alternative to surgical treatment for squamous cell carcinoma of the hand, as it is not only successful in eradicating tumour, but also preserves hand function.
Affiliation:
Department of Hand Surgery, Salford Royal Hospital, Salford M6 8HD, UK. brindavihari2001@yahoo.com
Citation:
Hand function after high dose rate brachytherapy for squamous cell carcinoma of the skin of the hand. 2008, 20 (9):691-7 Clin Oncol
Journal:
Clinical Oncology
Issue Date:
Nov-2008
URI:
http://hdl.handle.net/10541/67985
DOI:
10.1016/j.clon.2008.06.008
PubMed ID:
18693093
Type:
Article
Language:
en
ISSN:
0936-6555
Appears in Collections:
All Christie Publications ; Christie Medical Physics and Engineering Research; Clinical Oncology

Full metadata record

DC FieldValue Language
dc.contributor.authorSomanchi, B V-
dc.contributor.authorStanton, Anthony-
dc.contributor.authorWebb, M-
dc.contributor.authorLoncaster, Juliette A-
dc.contributor.authorAllan, Ernest-
dc.contributor.authorMuir, L T S W-
dc.date.accessioned2009-05-12T18:06:33Z-
dc.date.available2009-05-12T18:06:33Z-
dc.date.issued2008-11-
dc.identifier.citationHand function after high dose rate brachytherapy for squamous cell carcinoma of the skin of the hand. 2008, 20 (9):691-7 Clin Oncolen
dc.identifier.issn0936-6555-
dc.identifier.pmid18693093-
dc.identifier.doi10.1016/j.clon.2008.06.008-
dc.identifier.urihttp://hdl.handle.net/10541/67985-
dc.description.abstractAIMS: Current recommendations for the treatment of squamous cell carcinoma of the hand are almost unanimously in favour of ablative surgery. However, many of the patients are frail and elderly, and surgical techniques frequently involve skin grafts or amputation of digits. A non-invasive method of treatment is, therefore, often preferred. Radiotherapy using a brachytherapy technique is a well-established option. This study investigated whether patients found the treatment acceptable and assessed the outcome of treatment in terms of local control, cosmesis and hand function. MATERIALS AND METHODS: Twenty-five patients who underwent mould brachytherapy using a microselectron high dose rate radiotherapy device were available for assessment. We assessed the functional status of the hand and fingers by means of the Disability of Arm, Shoulder and Hand and Michigan Hand Outcomes questionnaires. We examined the hand to assess the severity of post-radiation stigmata. We enquired as to patient acceptability of treatment and outcome. RESULTS: Of 25 patients who agreed to participate, the fingers were affected in 15 and the dorsum of the hand in 10. The mean age at the time of radiotherapy was 69 years (range 50-87). There were no significant differences in parameters, such as range of motion of fingers and wrist, hand/finger grip strength, between the treated and opposite sides. Sensation, including two-point discrimination, was not significantly different from the untreated hand. Seventeen patients had minor skin changes. No patient found the treatment painful or unacceptable. Twenty patients were very satisfied and five patients were moderately satisfied with the cosmetic result. CONCLUSIONS: We conclude that high dose rate brachytherapy is a safe and simple alternative to surgical treatment for squamous cell carcinoma of the hand, as it is not only successful in eradicating tumour, but also preserves hand function.en
dc.language.isoenen
dc.subjectSkin Canceren
dc.subjectSquamous Cell Carcinoma of the Handen
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshBrachytherapy-
dc.subject.meshCarcinoma, Squamous Cell-
dc.subject.meshDose-Response Relationship, Radiation-
dc.subject.meshFemale-
dc.subject.meshHand-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPatient Satisfaction-
dc.subject.meshProspective Studies-
dc.subject.meshQuestionnaires-
dc.subject.meshSkin Neoplasms-
dc.titleHand function after high dose rate brachytherapy for squamous cell carcinoma of the skin of the hand.en
dc.typeArticleen
dc.contributor.departmentDepartment of Hand Surgery, Salford Royal Hospital, Salford M6 8HD, UK. brindavihari2001@yahoo.comen
dc.identifier.journalClinical Oncologyen

Related articles on PubMed

All Items in Christie are protected by copyright, with all rights reserved, unless otherwise indicated.