Fabrini Maria Grazia, Perrone Franco, De Liguoro Mario, Cionini Luca
Department of Oncology, Pisa University, and Division of Radiotherapy, Azienda Ospedaliera Universitaria Pisana, via Roma 67, Pisa, Italy.
Brachytherapy. 2008 Jul-Sep;7(3):270-5. doi: 10.1016/j.brachy.2008.04.004. Epub 2008 Jul 2.
High-dose-rate (192)Ir-based brachytherapy can be used as an exclusive treatment of large skin tumors when teletherapy or surgery is not feasible. A case of an extended inoperable skin epithelioma of the hand is reported; the lesion involved the first finger, the tenar, the palm, and the back.
A detailed description of an individual case is reported. A customized mold was created for the patient, to administer a fractionated brachytherapy treatment in a reproducible way.
A total dose of 50Gy was administered in 10 fractions, after a time schedule of three fractions per week. The treatment was well tolerated and the acute effects (mainly, epitheliolysis) were resolved completely within a month after the treatment.
Nine months after the treatment, the malignant lesion completely disappeared and the cosmetic results are quite satisfactory. Therefore, we conclude that the treatment technique is well adaptable to any particular geometry and that the fractionation scheme has proven to be well tolerated and effective in tumor eradication.
当远距离放射治疗或手术不可行时，高剂量率（192）铱近距离放射治疗可作为大型皮肤肿瘤的唯一治疗方法。本文报告一例手部扩展性不可手术切除的皮肤上皮瘤病例；病变累及示指、鱼际、手掌和手背。
报告了一个个案的详细情况。为患者制作了定制模具，以便以可重复的方式进行分次近距离放射治疗。
按照每周三次分次的时间安排，分10次给予了总量50Gy的剂量。治疗耐受性良好，急性效应（主要是上皮溶解）在治疗后一个月内完全消退。
治疗九个月后，恶性病变完全消失，美容效果相当令人满意。因此，我们得出结论，该治疗技术可很好地适应任何特定的解剖结构，并且分次方案已被证明耐受性良好且在根除肿瘤方面有效。
