Dermatologic Radiotherapy

TO THE ENGLISH EDITION Ionizing radiation has played an important role in the treatment of skin diseases for many decades. With strict adherence to modern standards of radiation protection, radiotherapy is a safe and effective method that benefits many patients who cannot be treated adequately by other means. Although indications for dermatologic radiotherapy have decreased significantly due to advances in other therapeutic modalities, many dermatologists feel strongly that ionizing radiation is an integral part of dermatologic therapy that should not be relinquished to other specialties because of the highly specialized anatomic, pathologic, and technologic knowledge required. A recent survey of the National Program for Dermatology showed that 44% of 2,444 responding dermatologists use radiotherapy regularly for various skin conditions, particularly in the treatment of cutaneous carcinomas. Significantly, the American Board of Dermatology has decided to continue its requirement of special knowledge in dermatologic radiation therapy for board certification. Because I have taught this dermatologic subspecialty at various levels, both in Europe and in the United States, I readily agreed to accept Pro fessor Braun-Falco's invitation to cooperate with him and Dr. Lukacs in the preparation of the English edition of this new guide. The text deals mostly with modern concepts of dermatologic radiotherapy and empha sizes practical aspects of treatment. Although it is written as an introduc tion for young dermatologists, it may also be useful to experienced clinicians who want to keep up with recent developments in this field.

Radiation therapy of cutaneous cancers and other dermatologic disorders is not covered adequately in many current textbooks of dermatology and radiation oncology. This book is intended to fill that gap. Both text and illustrations are oriented toward the practical aspects of radiation therapy. The beginner will find a concise introduction to physical and biological principles, selec tion of radiation factors, dose definitions, indications for treatment, and radiation seque lae. The experienced dermatologist and radiation oncologist will find a detailed discussion of specific indications for various radiation techniques in different body regions. A special effort was made to add pertinent references to the world literature for those who wish to pursue particular topics still further. We have tried to include all major American and European publications of the last 20 years in our bibliography of more than 500 refer ences, and we also have attempted to review the most important scientific papers on prin ciples and practice of ionizing radiation therapy in a constructive way. We are grateful to Professor Gorson, Dr. Breneman, and Professor Lindel6f, who generously contributed chapters in their areas of expertise despite their many other com mitments.

In this book, leading experts in the dermatological and oncological field describe the use of radiation therapy for the treatment of the full range of dermatological malignancies – including basal cell carcinoma, squamous cell carcinoma, cutaneous lymphomas, Kaposi's sarcoma, melanoma, and Merkel cell tumor – as well as those precancerous lesions and non-malignant dermatological disorders which are amenable to radiation therapy. In each case the specific indications for the use of radiotherapy and its application are clearly explained with the aid of numerous high-quality illustrations. In addition, the book provides a concise introduction to physical and radiobiological principles, selection of radiation factors, dose definitions, radiation reactions, and risk assessments. The new edition has been thoroughly revised and updated to reflect advances in practical knowledge and clinical practice. It will be an invaluable source of information on the management of skin tumors and related non-malignant disorders for both dermatologists, oncologists and radiation oncologists.

Radiation therapy of cutaneous cancers and other dermatologic disorders is not covered adequately in many current textbooks of dermatology and radiation oncology. This book is intended to fill that gap. Both text and illustrations are oriented toward the practical aspects of radiation therapy. The beginner will find a concise introduction to physical and biological principles, selec tion of radiation factors, dose definitions, indications for treatment, and radiation seque lae. The experienced dermatologist and radiation oncologist will find a detailed discussion of specific indications for various radiation techniques in different body regions. A special effort was made to add pertinent references to the world literature for those who wish to pursue particular topics still further. We have tried to include all major American and European publications of the last 20 years in our bibliography of more than 500 refer ences, and we also have attempted to review the most important scientific papers on prin ciples and practice of ionizing radiation therapy in a constructive way. We are grateful to Professor Gorson, Dr. Breneman, and Professor Lindel6f, who generously contributed chapters in their areas of expertise despite their many other com mitments.

A number of vital therapeutic modalities are not covered adequately in current dermatology textbooks. This book is intended to fill that gap. It originated in a series of special lectures on modem applications of physical modalities given at recent annual meetings of the American Academy of Dermatology; the main topics were radiotherapy, electrosurgery, phototherapy, cryosurgery, and related therapeutic modalities. The authors, recognized authorities in their field, have included much addi tional information which could not be covered in the original lectures because of time limitations. The indications for modem dermatological x-ray therapy reflect the basic views of the recently published guide lines of the National Academy of Sciences-National Research Council. Both text and illustrations are oriented toward the practical aspects of therapy with physical modalities. A special effort was made to bring the contributions up to date; pertinent references have been added for those who wish to pursue particular topics still further. Where there is an apparent overlap between chapters, it was felt to be advantageous because different authors approached their subject from different perspectives. I am most grateful to the various authors who generously contributed despite their many other commitments. I wish, also, to thank the staff of Springer-Verlag for their advice and assistance in the preparation of the manuscript.

Photon Radiation Therapy for Skin Malignancies is a vital resource for dermatologists interested in radiation therapy, including the physics and biology behind treatment of skin cancers, as well as useful and pragmatic formulas and algorithms for evaluating and treating them. Dermatology has always been a field that overlaps multiple medical specialties and this book is no exception, with its focus on both dermatologists and radiation oncologists. It is estimated that between 2010 and 2020, the demand for radiation therapy will exceed the number of radiation oncologists practicing in the U.S. tenfold, which could profoundly affect the ability to provide patients with sufficient access to treatment. Photon Radiation Therapy for Skin Malignancies enhances the knowledge of dermatologists and radiation oncologists and presents them with the most up-to-date information regarding detection, delineation and depth determination of skin cancers, and appropriate biopsy techniques. In addition, the book also addresses radiation therapy of the skin and the skin’s reactions to radiation therapy.

Chemotherapy and radiotherapy for cancer can have devastating side effects on the skin of a patient. This innovative guide for both dermatologists and oncologists gives a good introduction both to therapy regimes and to dermatological management for medical professionals treating their patients.