Radiation for below the knee skin cancers: a single institution experience.
J Dermatolog Treat. 2019 Jul 11;:1-17
Authors: Barnes EA, Sinclair E, Assaad D, Fialkov J, Antonyshyn O, Tsao MN
Background: Historically, radiation to skin cancers for the lower legs has been avoided due to the perceived increased risk of radiation toxicity (poor wound healing, radiation necrosis). However, there is a paucity of published data regarding this perceived risk. Purpose: The objective was to review the risk of poor wound healing/radiation necrosis occurring post radiation and to determine rates of complete response (CR), partial response (PR) and progressive disease after radiation therapy Materials and methods: A retrospective review of patients treated with radiation for skin cancer below the knee was undertaken from Jan. 1, 2013 to May 31, 2018.â€‚ Results: A total of 25 patients with 39 below the knee skin sites were treated with radiation. Mean follow-up time was 19 months (range 3 months- 7.2 years). Crude CR, PR and progression rates for the treated lesions were 65%, 19% and 16% respectively. Four out of 23 (17%) patients developed Grade 3 skin toxicity. There were no grades 4 or 5 toxicities. Conclusions: For patients not eligible for surgery, radiation therapy is an option with a moderate chance of complete response (65%) and a 17% risk of poor wound healing/radiation necrosis.
PMID: 31294616 [PubMed - as supplied by publisher]
Three-Dimensional Imaging and Breast Measurements: How Predictable Are We?
Aesthet Surg J. 2018 May 15;38(6):616-622
Authors: Steen K, Isaac KV, Murphy BD, Beber B, Brown M
Background: Outcomes in aesthetic breast surgery are dependent on preoperative breast measurements. The accuracy of 3-dimensional (3D) imaging in measuring critical landmarks in augmentation mammaplasty surgery has not been described.
Objectives: We aimed to determine the predictability of 3D imaging compared to direct measurements.
Methods: Two raters measured the breasts of 28 women using four anthropometric (direct) measurements: sternal notch to nipple distance (Sn-N), nipple to midline (N-M), nipple to inframammary-fold distance under maximal stretch (N-IMF), and base width (BW). Measurements (indirect) were also obtained using 3D imaging. Statistical analysis was completed with Bland-Altman plots.
Results: Each rater collected 56 data points for each of the four measurements. This resulted in 224 data points per rater. The Sn-N measurement had a 0.05 cm (SD, 0.65) difference in the mean values obtained between direct and indirect measurements. N-M had a mean difference of 0.20 cm (SD, 0.62). The mean difference for BW was 1.26 cm (SD, 0.69 cm), and N-IMF showed a mean difference of 1.22 cm (SD, 0.74 cm). Three-dimensional imaging overestimated Sn-N, N-M, and BW, while it underestimated N-IMF.
Conclusions: Three-dimensional imaging has good utility and is most accurate for Sn-N and N-M measurements, which require frontal imaging of a standing patient. BW and N-IMF are less accurate due to obscured landmarks on frontal imaging. The medial and lateral aspects of the breast may be obscured when measuring BW on 3D imaging, which may explain this difference. N-IMF is a dynamic measurement, and as a result, 3D imaging has limited ability to measure this distance accurately.
Level of Evidence 3:
PMID: 29272355 [PubMed - indexed for MEDLINE]