title: HDR-plesiotherapy for the treatment of anogenital extramammary Paget's disease.
abstract: BACKGROUND
  Extramammary Paget disease (EMPD) is a rare condition that most commonly affects the anogenital region in the elderly. It may be associated with an underlying invasive carcinoma. Surgical excision is nowadays considered a standard treatment for extramammary Paget's disease, although this approach might not be suitable for all patients. Good rates of local control and cosmetic outcome have been achieved by using high-dose-rate (HDR) plesiotherapy in the treatment of skin tumors arising in different locations.
  
  
  METHODS
  We present the results observed in a patient with EMPD treated by HDR plesiotherapy with a custom-made mold up to a final dose of 54 Gy in 12 fractions of 450 cGy over 4 weeks.
  
  
  RESULTS
  After a follow-up of 18 months, the patient is alive and without evidence of local or distant relapse. Acute toxicity was acceptable and cosmetic result was considered as excellent.
  
  
  CONCLUSIONS
  This technique represents an attractive alternative for those patients who are not candidates for surgical procedures because of unacceptable risk of disfigurements or functional impairment, medical contraindications or patient preference.
authors.affiliation: Department of Radiation Oncology, Universitary Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: Soraya
authors.initials: S
authors.lastname: Marcos
authors.affiliation: Department of Radiation Oncology, Universitary Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Montero
authors.affiliation: Department of Radiation Oncology, Universitary Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Capuz
authors.affiliation: Department of Radiation Oncology, Universitary Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Martinez-Ollero
authors.affiliation: Department of Radiation Oncology, Universitary Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: Raúl
authors.initials: R
authors.lastname: Hernanz
authors.affiliation: Department of Radiation Oncology, Universitary Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Fernández
authors.affiliation: Department of Radiation Oncology, Universitary Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Polo
authors.affiliation: Department of Radiation Oncology, Universitary Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Ramos
keywords: Anogenital region; Custom-made mold; Extramammary Paget's disease; HDR plesiotherapy; Superficial brachytherapy