How do you treat non-melanomatous skin cancers in poorly vascularized tissue?
This is an elderly patient with a BCC/SCC over the shin who is not eligible for Mohs due to concern for wound-healing issues. Orthovoltage/superficial RT is not available. What dose, fractionation, and technique?
Answer from: Radiation Oncologist at Community Practice
BCC/SCC? An unusual differential. Was it biopsied?
If it meets anatomic, size, and depth criteria, radiation oncology options would include electronic brachytherapy. Would likely offer 40 Gy in 10 fractions, twice weekly. Of course, would need to travel to an appropriate facility.
Sign in or Register to read more
Answer from: Radiation Oncologist at Community Practice
I would agree with Dr. @Lawrence R. Dardick. I would favor a hypo fractionated approach esp. in a poorly vascularized disease (contingent on tolerance of subjacent tissues). Brachytherapy is also a consideration. Protracted fractionation is clearly reasonable but there is no advantage to "re-ox...
Answer from: at Community Practice
Is the primary goal "Cure" or "Control of symptoms"?
For BCC (depending on the subtype), another option would be utilizing Vascular Lasers in a way to debulk the tumor.
Imiquimod cream is possibly an option as well.
For SCC, depending on the sub-type, intralesional MTX or 5-FU.
Another considera...
Comments
Radiation Oncologist at Mountain Radiation Oncology
Thank you for your insight as a Dermatologist. Fo...
Thank you for your insight as a Dermatologist. Fo...
at Good Dermatology - Torrance, CA
The depth of the tumor(s) is definitely an importa...
The depth of the tumor(s) is definitely an importa...
Radiation Oncologist at Mountain Radiation Oncology
Thank you very much!
Thank you very much!
at Good Dermatology - Torrance, CA
I just want to add that dietary changes may impact...
I just want to add that dietary changes may impact...