title: Technique for axillary radiotherapy using computer-assisted planning for high-risk skin cancer.
abstract: High-risk skin cancer arising on the upper limb or trunk can cause axillary nodal metastases. Previous studies have shown that axillary radiotherapy improves regional control. There is little published work on technique. Technique standardization is important in quality assurance and comparison of results especially for trials. Our technique, planned with CT assistance, is presented. To assess efficacy, an audit of patients treated in our institution over a 15-month period was conducted. Of 24 patients treated, 13 were treated with radical intent, 11 with this technique. With a follow up of over 2 years, the technique had more than a 90% (10/11) regional control in this radical group. Both of the radical patients who were not treated according to the technique had regional failure. One case of late toxicity was found, of asymptomatic lymphoedema in a radically treated patient. This technique for axillary radiotherapy for regional control of skin cancer is acceptable in terms of disease control and toxicity as validated by audit at 2 years.
authors.affiliation: Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. gerald.fogarty@mia.net.au
authors.forename: G B
authors.initials: GB
authors.lastname: Fogarty
authors.forename: R
authors.initials: R
authors.lastname: Cassumbhoy
authors.forename: J M
authors.initials: JM
authors.lastname: Martin
authors.forename: M
authors.initials: M
authors.lastname: Fay
authors.forename: J
authors.initials: J
authors.lastname: Ainslie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D015266:Carcinoma, Merkel Cell / Q000532:radiotherapy*; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015182:Lymphatic Irradiation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008485:Medical Audit / Q000379:methods; D008545:Melanoma / Q000532:radiotherapy*; D008875:Middle Aged; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D012306:Risk; D012878:Skin Neoplasms / Q000532:radiotherapy*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D034941:Upper Extremity / Q000000981:diagnostic imaging