Pub Date : 2020-07-27DOI: 10.15406/ijrrt.2020.07.00276
R. M, Jayrekha Tadiparthi, Latha Muniswamy, M. Chethan, Karthik D Yadav
Lasers have been largely used in the field of dentistry, they provide a high quality, precision treatment modality with and a great reduction or lack of posttreatment pain, making the patient experience somewhat easier. Lasers play an integral part in treating oral mucosal lesions. Its use is not only limited to oral mucosal lesions alone but also stepping into the field of endodontics and periodontics. Lasers have already established itself in the field of surgery.
{"title":"Lasers: light in the dental office","authors":"R. M, Jayrekha Tadiparthi, Latha Muniswamy, M. Chethan, Karthik D Yadav","doi":"10.15406/ijrrt.2020.07.00276","DOIUrl":"https://doi.org/10.15406/ijrrt.2020.07.00276","url":null,"abstract":"Lasers have been largely used in the field of dentistry, they provide a high quality, precision treatment modality with and a great reduction or lack of posttreatment pain, making the patient experience somewhat easier. Lasers play an integral part in treating oral mucosal lesions. Its use is not only limited to oral mucosal lesions alone but also stepping into the field of endodontics and periodontics. Lasers have already established itself in the field of surgery.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121657242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-24DOI: 10.15406/ijrrt.2020.07.00275
Ben Alcevski, Tiarna Shearer, Yeen Yeong, G. Fogarty
Introduction Radiotherapy (RT) is a precise treatment usually given over multiple sessions with millimetre accuracy to the planned target. Patients undergoing RT require verification of the target area prior each treatment. Imaging with kilovoltage X-rays is usually used to verify the treatment volumes of solid internal tumours, but this process is unsuitable for skin cancers as it cannot visualise skin marks. When biopsying or treating skin cancers, there is a chance that other nearby benign skin structures can be confused with the lesion of concern. Templates using transparent sheets have been used to verify the treatment area. We present a series of cases to demonstrate our skin cancer verification technique using the humble A4 plastic sheet protector. Case series: Case 1 details the use of a plastic sheet template to correctly identify lesions that require biopsy. Cases 2 and 3 describe how templates are used for in-field verification prior to electron and superficial RT treatment, respectively. Case 4 shows how stored templates can be used to quantify recurrence. Conclusion: For skin cancer planning and verification, the A4 plastic sheet protector is easy to use, reproducible, economical and storable. It serves multiple purposes: to delineate areas of biopsy and treatment, to discover whether a recurrence is in-field or not, and to also verify where in vivo dosimetry should be measured.
{"title":"Techniques to verify the correct skin areas for biopsy, treatment, recurrence and in-vivo dosimetry using an A4 plastic sheet as template","authors":"Ben Alcevski, Tiarna Shearer, Yeen Yeong, G. Fogarty","doi":"10.15406/ijrrt.2020.07.00275","DOIUrl":"https://doi.org/10.15406/ijrrt.2020.07.00275","url":null,"abstract":"Introduction Radiotherapy (RT) is a precise treatment usually given over multiple sessions with millimetre accuracy to the planned target. Patients undergoing RT require verification of the target area prior each treatment. Imaging with kilovoltage X-rays is usually used to verify the treatment volumes of solid internal tumours, but this process is unsuitable for skin cancers as it cannot visualise skin marks. When biopsying or treating skin cancers, there is a chance that other nearby benign skin structures can be confused with the lesion of concern. Templates using transparent sheets have been used to verify the treatment area. We present a series of cases to demonstrate our skin cancer verification technique using the humble A4 plastic sheet protector. Case series: Case 1 details the use of a plastic sheet template to correctly identify lesions that require biopsy. Cases 2 and 3 describe how templates are used for in-field verification prior to electron and superficial RT treatment, respectively. Case 4 shows how stored templates can be used to quantify recurrence. Conclusion: For skin cancer planning and verification, the A4 plastic sheet protector is easy to use, reproducible, economical and storable. It serves multiple purposes: to delineate areas of biopsy and treatment, to discover whether a recurrence is in-field or not, and to also verify where in vivo dosimetry should be measured.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"358 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115942493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-20DOI: 10.15406/ijrrt.2020.07.00274
Narelle Williams, F. Boyle, A. Hong, Hsien Chan, E. Paton, Kerryn Miller, Z. Moutrie, Sinead Mulrennan, Bianca Karle, Gerald B Fobarty
Introduction: Whole brain radiotherapy (WBRT) is a common palliative treatment for brain metastases from solid tumours. Traditionally, it is given with opposed lateral fields causing total alopecia as hair-bearing scalp skin receives the full dose. Volumetric modulated arc therapy (VMAT) can deliver WBRT with a simultaneous integrated boost (SIB) to larger metastases whilst minimising dose to critical structures such as the hippocampus. This feasibility study aimed to test the hypothesis that a reduced dose to the scalp using a VMAT hair-sparing WBRT protocol would spare scalp hair and reduce alopecia at four weeks post treatment without compromising disease control at three months. Methods: The Hair Spare study (01.07 WBRTMel sub-study SS01.13) was an investigator-initiated, prospective feasibility study. A VMAT hair-sparing WBRT protocol was developed to limit the dose to the scalp to 16 Gray (Gy) in 15 fractions. The primary objective was the rate of alopecia at 4 weeks post RT as measured by CTCAE v4 and clinician and patient perception. Quality of life (QoL) was assessed at baseline, one month and three months post treatment with validated instruments including European Organisation for Research and Treatment of Cancer (EORTC) QoL Questionnaire (QLQ-C15-PAL+4) plus four additional questions specifically relating to hair, a visual analogue scale (VAS) to measure the perception of hair loss severity, and the total Chemotherapy-Induced Alopecia Distress Scale (CADS). Results: Nine patients with brain metastases from melanoma (6), breast (2) and lung (1) cancer were enrolled at the Mater Sydney Hospital, Crows Nest, Australia. At 4 weeks, 5 patients were evaluable: 4 reported moderate alopecia (CTCAE v4 Grade 2) and 1 reported mild alopecia (CTCAE v4 Grade 1). All 5 wore wigs or scarves to hide hair loss. Any amount of hair loss impacted QoL. Reduced hair loss compared to complete alopecia, as usually found with conventional WBRT, did not translate to a mean improvement in QoL. There was no symptomatic intracranial progression of disease while the patients remained on study. Two patients had MRI at 3 months, and both had evidence of intracranial progression of disease within the volume that had received prescription WBRT dose. From the data collected it seems that VMAT hair-sparing WBRT was well-tolerated. Conclusion: VMAT hair-sparing WBRT partially spared scalp hair at four weeks post WBRT and did not compromise symptomatic disease control during the study. The treating oncologists observed that the hair grew back quicker than with conventional WBRT, and that combined cytotoxic chemotherapy was additive to RT-induced alopecia. However, the study was not optimal in that data collection was hampered by patient availability. The patient population was too unwell to be followed up according to the protocol.
{"title":"Whole brain radiotherapy with partial hair-sparing technique-a feasibility study","authors":"Narelle Williams, F. Boyle, A. Hong, Hsien Chan, E. Paton, Kerryn Miller, Z. Moutrie, Sinead Mulrennan, Bianca Karle, Gerald B Fobarty","doi":"10.15406/ijrrt.2020.07.00274","DOIUrl":"https://doi.org/10.15406/ijrrt.2020.07.00274","url":null,"abstract":"Introduction: Whole brain radiotherapy (WBRT) is a common palliative treatment for brain metastases from solid tumours. Traditionally, it is given with opposed lateral fields causing total alopecia as hair-bearing scalp skin receives the full dose. Volumetric modulated arc therapy (VMAT) can deliver WBRT with a simultaneous integrated boost (SIB) to larger metastases whilst minimising dose to critical structures such as the hippocampus. This feasibility study aimed to test the hypothesis that a reduced dose to the scalp using a VMAT hair-sparing WBRT protocol would spare scalp hair and reduce alopecia at four weeks post treatment without compromising disease control at three months. Methods: The Hair Spare study (01.07 WBRTMel sub-study SS01.13) was an investigator-initiated, prospective feasibility study. A VMAT hair-sparing WBRT protocol was developed to limit the dose to the scalp to 16 Gray (Gy) in 15 fractions. The primary objective was the rate of alopecia at 4 weeks post RT as measured by CTCAE v4 and clinician and patient perception. Quality of life (QoL) was assessed at baseline, one month and three months post treatment with validated instruments including European Organisation for Research and Treatment of Cancer (EORTC) QoL Questionnaire (QLQ-C15-PAL+4) plus four additional questions specifically relating to hair, a visual analogue scale (VAS) to measure the perception of hair loss severity, and the total Chemotherapy-Induced Alopecia Distress Scale (CADS). Results: Nine patients with brain metastases from melanoma (6), breast (2) and lung (1) cancer were enrolled at the Mater Sydney Hospital, Crows Nest, Australia. At 4 weeks, 5 patients were evaluable: 4 reported moderate alopecia (CTCAE v4 Grade 2) and 1 reported mild alopecia (CTCAE v4 Grade 1). All 5 wore wigs or scarves to hide hair loss. Any amount of hair loss impacted QoL. Reduced hair loss compared to complete alopecia, as usually found with conventional WBRT, did not translate to a mean improvement in QoL. There was no symptomatic intracranial progression of disease while the patients remained on study. Two patients had MRI at 3 months, and both had evidence of intracranial progression of disease within the volume that had received prescription WBRT dose. From the data collected it seems that VMAT hair-sparing WBRT was well-tolerated. Conclusion: VMAT hair-sparing WBRT partially spared scalp hair at four weeks post WBRT and did not compromise symptomatic disease control during the study. The treating oncologists observed that the hair grew back quicker than with conventional WBRT, and that combined cytotoxic chemotherapy was additive to RT-induced alopecia. However, the study was not optimal in that data collection was hampered by patient availability. The patient population was too unwell to be followed up according to the protocol.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123362095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-14DOI: 10.23880/ijnmrs-16000130
Elin Manrique Julio, Belkis Palacio Villalba, Elías Alberto Bedoya Marrugo, M. D. Lengua
Introduction: Identifying the main advances in the pharmacological and clinical management of the pandemic COVID-19 and SARS-CoV-2, the most recent and currently taking lives worldwide, is to priority of the scientific community that to date have rehearsed and joined efforts in order to respond with effective treatments that stop the progression of the viral infection and manage to recover the patient. Objective: To document available information on the effects of the antimalarials chloroquine / hydroxychloroquine and mefloquine in severe acute respiratory syndrome, generated by SARS CoV-2, according to updates of the best scientific evidence, according to the evolution of the epidemic. Material and Methods: Descriptive documentary study consisting of the selection and review of scientific material whose subject is COVID-19 and SARS-CoV-2 based on published evidence from bibliographic sources seeking different therapeutic options to combat the disease at the same time ace necessary preventive measures plough implemented worldwide. The databases consulted were Scopus, Head office Pubmed and Scielo. Results: 132 articles related to the search were obtained in the first instance, of which they were filtered and prioritized by thematic relevance until 60 articles with to broad relationship were located. The largest number of articles was published between 2015 and 2020 (n = 26; 43.3%). It have been shown that the mechanism of today's SARS-CoV-2 is similar to that of SARS-CoV and MERS-CoV, in the same way; they share the symptoms shown by patients with COVID-19 such ace: fever, non-productive cough, dyspnea, myalgia, fatigue, normal or decreased white blood cell counts. Conclusions: The activity of hydroxychloroquine and chloroquine in viruses is the same since the mechanism of action of these two molecules is identical. Given the pandemic, the use of these drugs is suggested in the management of patients with SARS CoV-2 / COVID-19 infection that have no contraindication for their use and the cardiac toxicity derived from these ace to cause of mortality should not be forgotten, due to what therapy must be individualized. The mefloquine is not recommended due to its neurotoxic effect and association with neuropsychiatric adverse reactions.
{"title":"Activity of the chloroquine/hydroxychloroquine and mefloquine in front of the SARS-CoV-2","authors":"Elin Manrique Julio, Belkis Palacio Villalba, Elías Alberto Bedoya Marrugo, M. D. Lengua","doi":"10.23880/ijnmrs-16000130","DOIUrl":"https://doi.org/10.23880/ijnmrs-16000130","url":null,"abstract":"Introduction: Identifying the main advances in the pharmacological and clinical management of the pandemic COVID-19 and SARS-CoV-2, the most recent and currently taking lives worldwide, is to priority of the scientific community that to date have rehearsed and joined efforts in order to respond with effective treatments that stop the progression of the viral infection and manage to recover the patient. Objective: To document available information on the effects of the antimalarials chloroquine / hydroxychloroquine and mefloquine in severe acute respiratory syndrome, generated by SARS CoV-2, according to updates of the best scientific evidence, according to the evolution of the epidemic. Material and Methods: Descriptive documentary study consisting of the selection and review of scientific material whose subject is COVID-19 and SARS-CoV-2 based on published evidence from bibliographic sources seeking different therapeutic options to combat the disease at the same time ace necessary preventive measures plough implemented worldwide. The databases consulted were Scopus, Head office Pubmed and Scielo. Results: 132 articles related to the search were obtained in the first instance, of which they were filtered and prioritized by thematic relevance until 60 articles with to broad relationship were located. The largest number of articles was published between 2015 and 2020 (n = 26; 43.3%). It have been shown that the mechanism of today's SARS-CoV-2 is similar to that of SARS-CoV and MERS-CoV, in the same way; they share the symptoms shown by patients with COVID-19 such ace: fever, non-productive cough, dyspnea, myalgia, fatigue, normal or decreased white blood cell counts. Conclusions: The activity of hydroxychloroquine and chloroquine in viruses is the same since the mechanism of action of these two molecules is identical. Given the pandemic, the use of these drugs is suggested in the management of patients with SARS CoV-2 / COVID-19 infection that have no contraindication for their use and the cardiac toxicity derived from these ace to cause of mortality should not be forgotten, due to what therapy must be individualized. The mefloquine is not recommended due to its neurotoxic effect and association with neuropsychiatric adverse reactions.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123141141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-03DOI: 10.15406/ijrrt.2020.07.00271
Callista V Raharjo, Colin Chen, F. Lam, S. O'Neill, J. Almeida, J. Turner, Robyn Levingston, Anna O’ Keefe, I. Quin, G. Fogarty
Radiotherapy and surgery are both potential modalities for the definitive treatment of pelvic malignancies. Although surgery provides a histological specimen, enabling exact staging, radiotherapy is sometimes preferred as it provides patients the opportunity for organ conservation and therefore perhaps better quality post-treatment survivorship. Our case report details how three separate primary pelvic cancers (prostate, rectal, anal) in one patient were treated simultaneously with definitive radiotherapy. Patient was prescribed 80 Gy in 40 fractions to the planning target volume (PTV) prostate, 54 Gy to PTV anal canal, 45 Gy to the pelvis including PTV rectosigmoid junction and 36 Gy to the PTV inguinal lymph nodes that encompassed clinically negative nodes draining the anus, through the Volumetric Modulated Arc Therapy (VMAT) with 6MV photons. Mean doses to organs at risk (OAR) are 30.01 Gy to the bowel volume, 46.54 Gy to the bladder, 30.42 Gy to the femurs, and 61.84 Gy to the rectum. Radiation doses to the prostate and anal canal are consistent with conventional treatment doses with definitive radiotherapy. The rectal dose was accepted as part of the definitive treatment of rectal cancer following Endoscopic Mucosal Resection (EMR). This could only be achieved through the superior dose conformality of VMAT, maximising the dose given to tumour bearing PTV while minimising the dose to OARs which included normal pelvic structures. All three cancers remained under control at 4 years after treatment, with minimal late toxicity associated with the treatment received. Further RCTs in pelvic malignancies are needed to help clinicians and patients select the best treatments, to improve disease control while maintaining quality of survivorship.
{"title":"Volumetric modulated arc therapy (VMAT) provides the conformality that enables three separate simultaneous pelvic malignancies to be treated radically–a case study","authors":"Callista V Raharjo, Colin Chen, F. Lam, S. O'Neill, J. Almeida, J. Turner, Robyn Levingston, Anna O’ Keefe, I. Quin, G. Fogarty","doi":"10.15406/ijrrt.2020.07.00271","DOIUrl":"https://doi.org/10.15406/ijrrt.2020.07.00271","url":null,"abstract":"Radiotherapy and surgery are both potential modalities for the definitive treatment of pelvic malignancies. Although surgery provides a histological specimen, enabling exact staging, radiotherapy is sometimes preferred as it provides patients the opportunity for organ conservation and therefore perhaps better quality post-treatment survivorship. Our case report details how three separate primary pelvic cancers (prostate, rectal, anal) in one patient were treated simultaneously with definitive radiotherapy. Patient was prescribed 80 Gy in 40 fractions to the planning target volume (PTV) prostate, 54 Gy to PTV anal canal, 45 Gy to the pelvis including PTV rectosigmoid junction and 36 Gy to the PTV inguinal lymph nodes that encompassed clinically negative nodes draining the anus, through the Volumetric Modulated Arc Therapy (VMAT) with 6MV photons. Mean doses to organs at risk (OAR) are 30.01 Gy to the bowel volume, 46.54 Gy to the bladder, 30.42 Gy to the femurs, and 61.84 Gy to the rectum. Radiation doses to the prostate and anal canal are consistent with conventional treatment doses with definitive radiotherapy. The rectal dose was accepted as part of the definitive treatment of rectal cancer following Endoscopic Mucosal Resection (EMR). This could only be achieved through the superior dose conformality of VMAT, maximising the dose given to tumour bearing PTV while minimising the dose to OARs which included normal pelvic structures. All three cancers remained under control at 4 years after treatment, with minimal late toxicity associated with the treatment received. Further RCTs in pelvic malignancies are needed to help clinicians and patients select the best treatments, to improve disease control while maintaining quality of survivorship.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131668591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-20DOI: 10.15406/IJRRT.2020.07.00269
A. Cardozo-Saavedra, D. Villasboas-Rosciolesi, E. Carrillo-Villamizar, Sandra Menéndez-Sánchez, R. Bellviure-Meiro, A. García-Burillo, J. Castell‐Conesa
Inguinoscrotal hernia of the bladder is relatively uncommon, difficult to diagnose and remain a surgical challenge.[1,2,3,4] We report a 72-years-old man with a recent diagnosis of prostate neoplasm who underwent a Technetium-99 hidroximethylene-diphosphonate (Tc-99m HMDP) bone scintigraphy which reveals, as an incidental finding, a left inguinoscrotal hernia containing a portion of the urinary bladder.
{"title":"Inguinoscrotal bladder hernia: incidental finding on bone scintigraphy","authors":"A. Cardozo-Saavedra, D. Villasboas-Rosciolesi, E. Carrillo-Villamizar, Sandra Menéndez-Sánchez, R. Bellviure-Meiro, A. García-Burillo, J. Castell‐Conesa","doi":"10.15406/IJRRT.2020.07.00269","DOIUrl":"https://doi.org/10.15406/IJRRT.2020.07.00269","url":null,"abstract":"Inguinoscrotal hernia of the bladder is relatively uncommon, difficult to diagnose and remain a surgical challenge.[1,2,3,4] We report a 72-years-old man with a recent diagnosis of prostate neoplasm who underwent a Technetium-99 hidroximethylene-diphosphonate (Tc-99m HMDP) bone scintigraphy which reveals, as an incidental finding, a left inguinoscrotal hernia containing a portion of the urinary bladder.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126657866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-25DOI: 10.15406/IJRRT.2020.07.00268
L. Dwyer, Roger L Haddad, G. Fogarty
"Resection of skin cancer with graft or flap repair may be referred for local postoperative radiotherapy (PORT) to ensure local control." PORT needs to be delivered in a certain time frame after surgery, but this may impact on graft and flap survival. The purpose of this article is to pass on some experience our multidisciplinary team has acquired in order to assist in the management of these cases. Specifically, pertinent issues in patient assessment (history and examination), indications for PORT, the differences between a graft and a flap, and technical considerations in the prescription of radiotherapy to these are covered, accompanied by illustrative cases with appropriate photographs and diagrams. The principal findings are that a conservative approach may need to be taken to ensure graft and flap survival, with PORT reserved for a role in salvage. Other interesting cases cover the lack of acute radiation side effects in flaps; the tendency of acute radiation skin toxicity to move with gravity, and transplanted skin may have a different radiation sensitivity to that of its new environment. We hope that this article will be of use for the multidisciplinary skin oncology team. Further research is needed to validate and confirm our findings.
{"title":"Experiences when irradiating grafts and flaps for skin cancer","authors":"L. Dwyer, Roger L Haddad, G. Fogarty","doi":"10.15406/IJRRT.2020.07.00268","DOIUrl":"https://doi.org/10.15406/IJRRT.2020.07.00268","url":null,"abstract":"\"Resection of skin cancer with graft or flap repair may be referred for local postoperative radiotherapy (PORT) to ensure local control.\" PORT needs to be delivered in a certain time frame after surgery, but this may impact on graft and flap survival. The purpose of this article is to pass on some experience our multidisciplinary team has acquired in order to assist in the management of these cases. Specifically, pertinent issues in patient assessment (history and examination), indications for PORT, the differences between a graft and a flap, and technical considerations in the prescription of radiotherapy to these are covered, accompanied by illustrative cases with appropriate photographs and diagrams. The principal findings are that a conservative approach may need to be taken to ensure graft and flap survival, with PORT reserved for a role in salvage. Other interesting cases cover the lack of acute radiation side effects in flaps; the tendency of acute radiation skin toxicity to move with gravity, and transplanted skin may have a different radiation sensitivity to that of its new environment. We hope that this article will be of use for the multidisciplinary skin oncology team. Further research is needed to validate and confirm our findings.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127136402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-20DOI: 10.15406/IJRRT.2020.07.00267
L. Butcher, G. Fogarty, S. Sinclair, Hanna Kuchel, R. Paver
Skin cancer is the most common malignancy, is increasing in incidence, and occurs most commonly on the head and neck. Cancers of the nasal ala pose therapeutic challenges given the cosmetic and functional importance. Both surgery and radiotherapy (RT) have similar oncological outcomes. RT is tissue-conserving and may have an advantage in cosmetic and functional outcomes, but more comparative trials are needed. RT needs to be delivered well to avoid late effects such as skin atrophy, fibrosis and telangiectasia, which may increase with higher dose per fraction. We describe three cases of self-reported thinning of the nasal ala following definitive mildly hypofractionated superficial radiotherapy (SXRT) of 2.5 Gy per fraction. SXRT to skin cancers of the nasal alar with standard fractionation of at most 2 Gy per fraction may be important in ensuring excellent cosmetic outcomes and patient satisfaction.
{"title":"Less is more when treating the nasal ala with superficial radiotherapy","authors":"L. Butcher, G. Fogarty, S. Sinclair, Hanna Kuchel, R. Paver","doi":"10.15406/IJRRT.2020.07.00267","DOIUrl":"https://doi.org/10.15406/IJRRT.2020.07.00267","url":null,"abstract":"Skin cancer is the most common malignancy, is increasing in incidence, and occurs most commonly on the head and neck. Cancers of the nasal ala pose therapeutic challenges given the cosmetic and functional importance. Both surgery and radiotherapy (RT) have similar oncological outcomes. RT is tissue-conserving and may have an advantage in cosmetic and functional outcomes, but more comparative trials are needed. RT needs to be delivered well to avoid late effects such as skin atrophy, fibrosis and telangiectasia, which may increase with higher dose per fraction. We describe three cases of self-reported thinning of the nasal ala following definitive mildly hypofractionated superficial radiotherapy (SXRT) of 2.5 Gy per fraction. SXRT to skin cancers of the nasal alar with standard fractionation of at most 2 Gy per fraction may be important in ensuring excellent cosmetic outcomes and patient satisfaction.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"101 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133819173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-30DOI: 10.15406/IJRRT.2020.07.00265
Mayra Campos Frâncica dos Santos, J. P. M. Santos, Rubens Alexandre da Silva Junior, R. A. P. Ferrari, L. M. Iida, R. Andraus, Sue Ellen Ferreira Modesto Rey de Figueiredo, K. Fernandes
Objective: to analyze the prevalence of psychological disorders (anxiety, depression, stress) and the relationship of these factors with functional disability in patients with chronic low back pain. Study design: cross-sectional descriptive and observational study. Setting: the physiotherapy outpatient clinic of the Northen University of Paraná, Londrina, Paraná, Brazil. Methods: 84 individuals were recruited, being 43 elderly (20 with low back pain and 23 control subjects) and 41 adults (21 with low back pain and 20 control subjects). In order to assess the psychological aspects, Beck Inventories of Depression and anxiety as well as Lipp Stress Inventory were used. To evaluate the funcionality, Roland Morris Questionnaire was chosen. The evaluation of the pressure pain threshold was performed using algometer emg systems®. To analyse was considered a significance level of 5% (p<0.05). Results: It was observed that people with low back pain have higher scores of depression, anxiety, stress and functional disability compared to the control group (p<0.05). Among adults, an inverse relationship between anxiety and disability (p<0.05) was observed. In subjects with low back pain positive correlation was observed between anxiety and functional disability and, between the depression and functional disability (p<0.05). In addition, no association was found between stress and functional disability in patients with low back pain (p<0.05). Conclusion: suggest that in patients with low back pain worsening of functionality is anxiety and stress and elderly people with low back pain has higher levels of stress, depression, anxiety and function disability.
{"title":"Emotional and disability status in patients with chronic low back pain","authors":"Mayra Campos Frâncica dos Santos, J. P. M. Santos, Rubens Alexandre da Silva Junior, R. A. P. Ferrari, L. M. Iida, R. Andraus, Sue Ellen Ferreira Modesto Rey de Figueiredo, K. Fernandes","doi":"10.15406/IJRRT.2020.07.00265","DOIUrl":"https://doi.org/10.15406/IJRRT.2020.07.00265","url":null,"abstract":"Objective: to analyze the prevalence of psychological disorders (anxiety, depression, stress) and the relationship of these factors with functional disability in patients with chronic low back pain. Study design: cross-sectional descriptive and observational study. Setting: the physiotherapy outpatient clinic of the Northen University of Paraná, Londrina, Paraná, Brazil. Methods: 84 individuals were recruited, being 43 elderly (20 with low back pain and 23 control subjects) and 41 adults (21 with low back pain and 20 control subjects). In order to assess the psychological aspects, Beck Inventories of Depression and anxiety as well as Lipp Stress Inventory were used. To evaluate the funcionality, Roland Morris Questionnaire was chosen. The evaluation of the pressure pain threshold was performed using algometer emg systems®. To analyse was considered a significance level of 5% (p<0.05). Results: It was observed that people with low back pain have higher scores of depression, anxiety, stress and functional disability compared to the control group (p<0.05). Among adults, an inverse relationship between anxiety and disability (p<0.05) was observed. In subjects with low back pain positive correlation was observed between anxiety and functional disability and, between the depression and functional disability (p<0.05). In addition, no association was found between stress and functional disability in patients with low back pain (p<0.05). Conclusion: suggest that in patients with low back pain worsening of functionality is anxiety and stress and elderly people with low back pain has higher levels of stress, depression, anxiety and function disability.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124880736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}