| Title |
Photon irradiation using a water bath technique for treatment of confluent carcinoma in situ of the hand, digits, and nail bed: a case report
|
|---|---|
| Published in |
Journal of Medical Case Reports, March 2017
|
| DOI | 10.1186/s13256-017-1233-3 |
| Pubmed ID | |
| Authors |
Chelain R. Goodman, Albert DeNittis |
| Abstract |
Confluent squamous cell carcinoma in situ, or Bowen's disease, involving the hand, digit, and nail bed is rare and represents a significant therapeutic challenge. Surgical excision is recommended as first-line treatment but in cases of extensive disease can lead to unacceptable functional morbidity or cosmetic outcomes. Radiation therapy has been shown to be equally efficacious to surgery in the treatment of carcinoma in situ but its use has historically been limited due to concerns regarding toxicity. In this case report we present a novel therapeutic technique that may enable radiotherapy to be employed as a definitive treatment option in these challenging cases. A 75-year-old white man with a previous history of carcinoma in situ of his right hand previously treated with 5-fluorouracil presented with recurrent biopsy-proven confluent squamous cell carcinoma in situ of multiple surfaces of his right hand and digits with involvement of nail beds. To avoid extensive resection and possible amputation he was offered definitive external beam radiation therapy utilizing a water bath as a tissue-equivalent bolus material. This protocol enabled improved dose homogeneity to the target volume while minimizing acute toxicity. He experienced complete clinical resolution of the disease with only minimal acute edema and hyperpigmentation. Twenty months following treatment completion he remains disease-free with normal function and excellent cosmesis. Therapeutic radiation utilizing water as a tissue-equivalent bolus in this complicated case enabled definitive treatment of disease without compromising functional or cosmetic outcomes. Radiotherapy may therefore be an alternative and under-utilized approach to surgical excision in difficult-to-treat cases of carcinoma in situ. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 20 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 20 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 5 | 25% |
| Student > Master | 3 | 15% |
| Professor | 2 | 10% |
| Student > Ph. D. Student | 2 | 10% |
| Student > Bachelor | 1 | 5% |
| Other | 1 | 5% |
| Unknown | 6 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 6 | 30% |
| Psychology | 2 | 10% |
| Nursing and Health Professions | 1 | 5% |
| Agricultural and Biological Sciences | 1 | 5% |
| Energy | 1 | 5% |
| Other | 1 | 5% |
| Unknown | 8 | 40% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 April 2017.
All research outputs
#18,540,642
of 22,962,258 outputs
Outputs from Journal of Medical Case Reports
#2,274
of 3,939 outputs
Outputs of similar age
#234,934
of 308,953 outputs
Outputs of similar age from Journal of Medical Case Reports
#49
of 97 outputs
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