How do you prevent non-healing ulcer when treating patients with cutaneous SCC of the distal lower extremity who have peripheral vascular disease?
These patients are often not surgical candidates, but radiation complications may also be underappreciated. Do you refer to vascular surgery prior to treatment? Reflex hyperbaric O2 after treatment completion? Any other strategies?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · Duke University Medical Center
Answered on
@Dr. First Last points are well taken but he does not mention dose fractionation. For most skin cancers, I usually treated with a fairly short course of RT , e.g. 400×10, but not in this situation, where a longer course, e.g. 60-70 Gy in 2 Gy fxs may be desirable.
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Mednet Member
Radiation Oncology · Emory University School of Medicine
Answered on
In my experience, here is no perfect answer. Making sure all factors, as best as possible, are attended to: the patient has quit or reduced smoking during the treatment and is getting active support to do so, blood sugar (diabetes) is under control, foot care is being delivered if this is an issue, ...
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