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Title: Adjuvant Radiation of Bilateral Postauricular Keloids: An Illustration of Technique

Abstract

Treatment of keloids can be diverse and, frequently, in cases of recurrence, patients are referred for postoperative radiation therapy. Some sites known for keloid formation, such as the postauricular surface, can create a technical challenge. Because of the need for treatment so soon after surgery, physical manipulation of the freshly operated area to accommodate exposure for electron (or other) therapy is difficult. We were recently asked to evaluate a patient requiring treatment of both postauricular spaces. Literature describing techniques for such a case is scant, and we felt it would be helpful to describe and depict our setup and treatment course.

Authors:
 [1]; ;  [2]
  1. Department of Radiation Medicine, University of Kentucky, Chandler Medical Center, Lexington, KY (United States), E-mail: jhuhn0@uky.edu
  2. Department of Radiation Medicine, University of Kentucky, Chandler Medical Center, Lexington, KY (United States)
Publication Date:
OSTI Identifier:
21045983
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Dosimetry; Journal Volume: 32; Journal Issue: 4; Other Information: DOI: 10.1016/j.meddos.2007.02.009; PII: S0958-3947(07)00050-7; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
61 RADIATION PROTECTION AND DOSIMETRY; ELECTRON BEAMS; NEOPLASMS; PATIENTS; RADIOTHERAPY; SURGERY

Citation Formats

Huhn, Jeniffer L., Johnson, E. Lee, and St Clair, William. Adjuvant Radiation of Bilateral Postauricular Keloids: An Illustration of Technique. United States: N. p., 2007. Web. doi:10.1016/j.meddos.2007.02.009.
Huhn, Jeniffer L., Johnson, E. Lee, & St Clair, William. Adjuvant Radiation of Bilateral Postauricular Keloids: An Illustration of Technique. United States. doi:10.1016/j.meddos.2007.02.009.
Huhn, Jeniffer L., Johnson, E. Lee, and St Clair, William. Mon . "Adjuvant Radiation of Bilateral Postauricular Keloids: An Illustration of Technique". United States. doi:10.1016/j.meddos.2007.02.009.
@article{osti_21045983,
title = {Adjuvant Radiation of Bilateral Postauricular Keloids: An Illustration of Technique},
author = {Huhn, Jeniffer L. and Johnson, E. Lee and St Clair, William},
abstractNote = {Treatment of keloids can be diverse and, frequently, in cases of recurrence, patients are referred for postoperative radiation therapy. Some sites known for keloid formation, such as the postauricular surface, can create a technical challenge. Because of the need for treatment so soon after surgery, physical manipulation of the freshly operated area to accommodate exposure for electron (or other) therapy is difficult. We were recently asked to evaluate a patient requiring treatment of both postauricular spaces. Literature describing techniques for such a case is scant, and we felt it would be helpful to describe and depict our setup and treatment course.},
doi = {10.1016/j.meddos.2007.02.009},
journal = {Medical Dosimetry},
number = 4,
volume = 32,
place = {United States},
year = {Mon Jan 01 00:00:00 EST 2007},
month = {Mon Jan 01 00:00:00 EST 2007}
}
  • Purpose: Irradiation of adjuvant lymph nodes in high-risk prostate cancer was shown to be associated with improved rates of biochemical nonevidence of disease in the Radiation Therapy Oncology Group trial (RTOG 94-13). To account for the highly individual lymphatic drainage pattern we tested an intensity-modulated radiation therapy (IMRT) approach based on the determination of pelvic sentinel lymph nodes (SN). Methods and Materials: Patients with a risk of more than 15% lymph node involvement were included. For treatment planning, SN localizations were included into the pelvic clinical target volume. Dose prescriptions were 50.4 Gy to the adjuvant area and 70.0 Gymore » to the prostate. All treatment plans were generated using equivalent uniform dose (EUD)-based optimization algorithms and Monte Carlo dose calculations and compared with 3D conventional plans. Results: A total of 25 patients were treated and 142 SN were detectable (mean: n = 5.7; range, 0-13). Most SN were found in the external iliac (35%), the internal iliac (18.3%), and the iliac commune (11.3%) regions. Using a standard CT-based planning target volume, relevant SN would have been missed in 19 of 25 patients, mostly in the presacral/perirectal area (22 SN in 12 patients). The comparison of conventional 3D plans with the respective IMRT plans revealed a clear superiority of the IMRT plans. No gastrointestinal or genitourinary acute toxicity Grade 3 or 4 (RTOG criteria) occurred. Conclusions: Distributions of SN are highly variable. Data for SN derived from single photon emission computed tomography are easily integrated into an IMRT-based treatment strategy. By using SN data the probability of a geographic miss is reduced. The use of IMRT allows sparing of normal tissue irradiation.« less
  • A summary is given of the results of radiation and combined treatment of 75 keloids with radon preparations, radioactive cobalt, and gold. The best results were obtained in treating postoperative keloids (out of 8 cases, good results were seen in 6 and satisfactory in 1 patient) and spontaneous keloids (out of 12 patients, good results were obtained in 8 and satisfactory in 3 cases). The results were somewhat inferior in the group of spontaneous keloids treated by excision prior to the radiation therapy (out of 15 patients, good results were obtained in 3 and satisfactory in 6 patients). Radiation therapymore » proved to be the least effective in keloids resulting from burn (out of 18 patients, satisfactory results were seen in 10 cases and good in 1 patient). Good cosmetic effect in treatment of keloids rising considerably above the skin surface was reached only in combined therapy. The most favorable results were obtained with a dose of 4,000 r, the dose rate being 70 to 100 r/hr, with fractional irradiation. (auth)« less
  • Purpose: To study the impact of postoperative radiation therapy (PORT) on survival in the Adjuvant Navelbine International Trialist Association (ANITA) randomized study of adjuvant chemotherapy. Methods and Materials: ANITA is a randomized trial of adjuvant cisplatin and vinorelbine chemotherapy vs. observation in completely resected non-small-cell lung carcinoma (NSCLC) Stages IB to IIIA. Use of PORT was recommended for pN+ disease but was not randomized or mandatory. Each center decided whether to use PORT before initiation of the study. We describe here the survival of patients with and without PORT within each treatment group of ANITA. No statistical comparison of survivalmore » was performed because this was an unplanned subgroup analysis. Results: Overall, 232 of 840 patients received PORT (33.3% in the observation arm and 21.6% in the chemotherapy arm). In univariate analysis, PORT had a deleterious effect on the overall population survival. Patients with pN1 disease had an improved survival from PORT in the observation arm (median survival [MS] 25.9 vs. 50.2 months), whereas PORT had a detrimental effect in the chemotherapy group (MS 93.6 months and 46.6 months). In contrast, survival was improved in patients with pN2 disease who received PORT, both in the chemotherapy (MS 23.8 vs. 47.4 months) and observation arm (median 12.7 vs. 22.7 months). Conclusion: This retrospective evaluation suggests a positive effect of PORT in pN2 disease and a negative effect on pN1 disease when patients received adjuvant chemotherapy. The results support further evaluation of PORT in prospectively randomized studies in completely resected pN2 NSCLC.« less
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  • The radiation reaction of a BPS monopole in the presence of incident electromagnetic waves as well as massless Higgs waves is analyzed classically. The reactive force and higher-order (finite size) effect are compared to those of the W boson that is interpreted as a dual partner of the BPS monopole. It is shown that the damping of acceleration is dual to each other, while in the case of the finite size effect the duality is broken explicitly. Their implications on the duality are discussed. {copyright} {ital 1997} {ital The American Physical Society}