• Login
    View Item 
    •   Home
    • The Christie Research Publications Repository
    • All Christie Publications
    • View Item
    •   Home
    • The Christie Research Publications Repository
    • All Christie Publications
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of ChristieCommunitiesTitleAuthorsIssue DateSubmit DateSubjectsThis CollectionTitleAuthorsIssue DateSubmit DateSubjectsProfilesView

    My Account

    LoginRegister

    Local Links

    The Christie WebsiteChristie Library and Knowledge Service

    Statistics

    Display statistics

    Superficial HDR brachytherapy for skin lesions involving the finger - The Christie experience

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Authors
    Rembielak, Agata
    Bedford, J
    Wilson, S.
    Affiliation
    The Christie NHS Foundation Trust, Clinical Oncology, Manchester
    Issue Date
    2021
    
    Metadata
    Show full item record
    Abstract
    Purpose or Objective The standard of care for treatment of skin cancer and refractory precancerous conditions located on the finger is largely surgical management. Surgery usually involves digits/finger amputation or wide local excision with reconstruction. Many patients are elderly and/or frail. Non-invasive methods of treatment are often the preferred option due to favourable cosmetic and/or functional outcomes and improved patient compliance. External beam radiotherapy in finger location is challenging due to depth-dose characteristics in curved surfaces and close target location to joints and bones. HDR brachytherapy (BT) is a well-established non-invasive alternative treatment option delivering high radiation dose to the target with rapid dose fall-off in normal surrounding tissues. We report The Christie experience with HDT BT in the finger location over the past 6 years. Materials and Methods From Jan 2014 to Sept 2020, 13 patients (7 males and 5 females) underwent radical superficial HDR BT to the finger. There were 9 skin SCCs: 5 postoperative and 4 definitive. One patient had BCC and 3 patients had progressive refractory Bowen’s disease. The median age at the time of BT was 71 years (range 52 – 95). The patients were treated with a total dose of 30–34 Gy at 100% isodose in 8 fractions twice a day at least 6 hours apart. Target area was marked out by visual inspection, palpation and high frequency skin ultrasound. All patients were treated with The Christie mould technique: a flap mounted over an individually designed mould composed of a pre-calculated number of layers of thermoplastic material. Patients were followed for at least 2-3 years for treatment toxicity, cosmetic results, and local failures. Acute toxicity was graded using the CTC AE, v. 4.0 and cosmetic outcomes were classified using the RTOG cosmetic rating scale. Results Average follow-up from completion of the treatment was 23.5 months (2-36 months). All patients had an acute reaction to the BT: desquamation, crusting and erythema grade 1 or 2. One patient developed acute grade 3 wet desquamation. All acute toxicity was resolved within 2 months after treatment. Late toxicity was reported in 6 patients: slight/moderate atrophy, pigmentation change and grade 1 or 2 teleangiectasia. No cosmetic or functional results worse than good were observed. 11 patients had no evidence of recurrence in follow-up. 2 patients proceeded to salvage surgery due to either no response to BT or local recurrence at 4 months after BT. 2/11 patients passed away due to non-cancer related causes. Conclusion HDR mould BT is a valid non-invasive alternative to surgical management of skin cancer and refractory precancerous conditions located on the finger. It has its role particularly in elderly where PS and comorbidities may preclude surgery and short treatment duration can help with patient compliance. With appropriate patient selection skin HDR BT with customized surface moulds offers a good outcome and favourable cosmetic results with function preservation.
    Citation
    Rembielak A, Bedford J, Wilson S. OC-0019 Superficial HDR brachytherapy for skin lesions involving the finger – The Christie experience. Radiotherapy and Oncology . 2021 May;158:S10–1. 
    Journal
    Radiotherapy and Oncology
    URI
    http://hdl.handle.net/10541/624215
    Type
    Meetings and Proceedings
    Language
    en
    Collections
    All Christie Publications

    entitlement

     
    DSpace software (copyright © 2002 - 2025)  DuraSpace
    Quick Guide | Contact Us
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.