Doggett Stephen, Brazil James, Limova Marketa, Press Leah, Smith Sidney, Peck Jeremy
Aegis Oncology, Tustin, CA.
Olympic Dermatology, Olympia, WA.
J Contemp Brachytherapy. 2017 Apr;9(2):158-160. doi: 10.5114/jcb.2017.65454. Epub 2017 Jan 25.
To evaluate the suitability of treating atypical fibroxanthoma (AFX), an uncommon skin malignancy, with electronic brachytherapy.
From Feb 2013 to Sep 2014, we were referred a total of 8 cases of AFX in 7 patients, all involving the scalp. All of them were treated with electronic brachytherapy 50 Kev radiations (Xoft Axxent, Fremont, California). All lesions received 40 Gy in two fractions per week with 5mm margins.
At a median follow-up of 23.7 months, the local recurrence rate is 12.5%. The single lesion that failed was not debulked surgically prior to electronic brachytherapy.
To our knowledge, this is the first report in the literature on the use of radiation therapy as curative primary treatment for AFX. No contraindication to the use of radiations is found in the literature, with surgery being the sole treatment for AFX noted. Our recurrence rate is 0% for debulked lesions. Risk of recurrence is mitigated with surgical debulking prior to brachytherapy. Electronic brachytherapy appears to be a safe and effective treatment for debulked AFX. Multiple excisions, skin grafting, and wound care can be avoided in elderly patients by the use of electronic brachytherapy.
评估采用电子近距离放射治疗非典型纤维黄色瘤（AFX，一种罕见的皮肤恶性肿瘤）的适用性。
2013年2月至2014年9月，我们共接收了7例患者的8例AFX病例，均累及头皮。所有病例均采用50千电子伏特辐射的电子近距离放射治疗（加利福尼亚州弗里蒙特市的Xoft Axxent）。所有病灶每周分两次给予40 Gy，边缘为5毫米。
中位随访23.7个月时，局部复发率为12.5%。唯一治疗失败的病灶在电子近距离放射治疗前未进行手术减瘤。
据我们所知，这是文献中关于将放射治疗作为AFX的根治性初始治疗的首篇报道。文献中未发现使用放射治疗的禁忌证，仅提及手术是AFX的唯一治疗方法。我们对减瘤后的病灶的复发率为0%。在近距离放射治疗前进行手术减瘤可降低复发风险。电子近距离放射治疗似乎是一种治疗减瘤后AFX的安全有效的方法。通过使用电子近距离放射治疗，老年患者可避免多次切除、植皮和伤口护理。
