skin malignancies

  • 文章类型: Case Reports
    外阴鳞状细胞癌(VSCC)是最常见的外阴瘤,具有侵袭性和转移性。通常,手术是首选治疗方法。放射疗法通常用于不可切除的局部晚期肿瘤和早期患者,这些患者有手术严重并发症的风险或患有严重的伴随疾病,从而阻止他们进行手术。与外照射相比,三维适形放射治疗(3D-CRT),和调强放射治疗(IMRT),在早期VSCC中单独使用体积调节电弧疗法(VMAT)的各种研究很少有报道.在这种情况下,患者有大面积皮肤损伤,无淋巴结转移。手术切除会严重影响排尿功能和外阴形状,所以进行了根治性放疗。为了保证根治性治疗效果的辐射剂量,避免高剂量辐射到正常器官,选择容积调强放疗技术.治疗后,病人的外阴外观恢复正常,肿瘤完全缓解,无需进一步手术或化疗,没有局部复发或相关的毒副作用。提示单纯VMAT治疗早期VSCC疗效准确,值得临床推广。该患者从事铜冶炼和净化工作多年,对她来说,皮肤损伤如此大的表面积是不寻常的。结合她以前的鼻基底细胞癌病史,金属暴露过程中的氧化应激机制应进一步进行临床检查,因为它可能在恶性肿瘤的形成和进展中至关重要。
    Vulvar squamous cell carcinoma (VSCC) is the most frequent vulvar neoplasia, with invasiveness and metastasis. Typically, surgery is the preferred treatment. Radiotherapy is commonly used for unresectable locally advanced tumors and for early-stage patients who are at risk of serious complications from surgery or have a severe concomitant disease that prevents them from undergoing surgery. Compared to external irradiation, three-dimensional conformal radiotherapy (3D-CRT), and intensity-modulated radiotherapy (IMRT), various studies using volumetric modulated arc therapy (VMAT) alone in early-stage VSCC have been reported rarely. In this case, the patient had a large skin lesion and no lymph node metastasis. Surgical excision would seriously affect the urinary function and vulvar shape, so radical radiotherapy was given. To ensure the radiation dose for the radical treatment effect and to avoid high-dose radiation to normal organs, the volumetric intensity-modulated radiotherapy technique was chosen. After treatment, the patient\'s vulvar appearance returned to normal, and the tumor achieved complete remission without further surgery or chemotherapy, with no local recurrence or associated toxic side effects. This suggests that the efficacy of VMAT alone in early-stage VSCC is accurate and worthy of clinical promotion. The patient had been engaged in copper smelting and purification for many years, and it is unusual for her to have skin lesions with such a large surface area. In conjunction with her previous history of nasal basal cell carcinoma, the mechanism of oxidative stress during metal exposure should be further clinically examined, as it may be crucial in the formation and progression of malignancies.
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