Presented by Dr. Michael Webster
Hot Spots in Dermatology
August 17, 2018
- What’s new?
- VMAT for treating large areas (whole arm,leg) for actinic keratoses/NMSC
- A treatment for Disseminated Actinic Porokeratosis ?
- Volumetric modulated arc therapy (Elektra)
- Delivers the radiotherapy treatment using a rotational or arc geometry rather than several static beams .
- Gantry motion,variable dose rate,movement of multileaf collimators
- Computerised planning using Ct scan allows treatment to be delivered to tumour with minimal exposure to adjacent tissues
- VMAT for skin
Can be set to give radiation just to skin & subcutaneous tissue circumferentially (with minimal exposure to deeper tissues) allowing treatment of a whole limb ,scalp,or head & neck area.
Genesis Care is trialling this Rx for treatment of NMSC & actinic keratoses over large areas
25 x 2Gy over 5 weeks
- Grenz ray for DSAP
- Successful Use of Grenz rays for DSAP
E Rameltye et al Dermatology 2017;233:217-222
Retrospective study 8 pts age 54-84
7/8 complete clinical clearing
f/u 2-65/12 (median 21.4) 1pt had 1 relapse lesion (46/12)
Total dose per field 28-52 Gy. (4Gy fractions)
No NMSC in treated areas
- Grenz & DSAP
- Ricci C ,Rosset A,Panizzon RG Bullous&pruritic variant of DSAP:successful treatment with Grenz rays Dermatology 1999;199:328-331
- Case report no details of treatment
- Our experience
- 2 patients 6 x 4Gy both developed reactions –essentially clear –pts very happy