This document discusses the effects of ionizing radiation on skin, including both acute and late effects. It notes that radiation can cause a range of skin reactions from mild erythema to moist desquamation and ulceration. The degree of injury depends on factors like total radiation dose and time interval. Acute effects involve cellular and inflammatory changes in the epidermis and dermis over hours to weeks. Late effects like fibrosis, telangiectasias, and delayed wound healing can occur months to years later. Risk factors include age, gender, and technical factors like radiation dose and site. Several scoring systems are presented to grade skin reactions. Treatment focuses on wound care, topical agents, antibiotics and growth factors to promote healing
The combined use of radiation therapy and chemotherapy in cancer treatment is a logical and reasonable approach that has already proven beneficial for several malignancies.
The combined use of radiation therapy and chemotherapy in cancer treatment is a logical and reasonable approach that has already proven beneficial for several malignancies.
EBCTCG METAANALYSIS
INDICATION OF POST OP RADIOTHERAPY
Immobilization devices
Conventional planning
Alignment of the Tangential Beam with the Chest Wall Contour
Doses To Heart & Lung By Tangential Fields
Learn about the process of radiation therapy to treat soft tissue sarcoma, and how new radiation technology has improved treatment of the disease.
This presentation was given by Elizabeth H. Baldini, MD, MPH, radiation oncology director for the Center for Sarcoma and Bone Oncology at Dana-Farber Cancer Institute. It was originally presented as part of the "15 Years of GIST/Soft Tissue Sarcoma Symposium," held on Sept. 12, 2015 at Dana-Farber in Boston, Mass.
Particle beam – proton,neutron & heavy ion therapyAswathi c p
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EBCTCG METAANALYSIS
INDICATION OF POST OP RADIOTHERAPY
Immobilization devices
Conventional planning
Alignment of the Tangential Beam with the Chest Wall Contour
Doses To Heart & Lung By Tangential Fields
Learn about the process of radiation therapy to treat soft tissue sarcoma, and how new radiation technology has improved treatment of the disease.
This presentation was given by Elizabeth H. Baldini, MD, MPH, radiation oncology director for the Center for Sarcoma and Bone Oncology at Dana-Farber Cancer Institute. It was originally presented as part of the "15 Years of GIST/Soft Tissue Sarcoma Symposium," held on Sept. 12, 2015 at Dana-Farber in Boston, Mass.
Particle beam – proton,neutron & heavy ion therapyAswathi c p
particle therapy is advanced external beam therapy used to treat cancer , which uses beams of protons or other charged particles such as helium, carbon or other ions instead of photons. charged particles have different depth-dose distributions compared to photons. They deposit most of their energy in the last final millimeters of their trajectory (when their speed slows). This results in a sharp and localized peak of dose, known as the Bragg peak.
ned as the development of new radiculopathy or myelopathy of a motion segment adjacent to the site of a previous arthrodesis of the spine (either superior or inferior).1 Studies have shown that the prevalence of symptomatic ASD ranges from 9 to 17%, with an annual incidence be- tween 1.5% and 4% in patients who under- went anterior cervical diskectomy and fusion.24 Although there is controversy surrounding the origins of ASD and whether or not it is a function of surgery or a natural progression of disease, multiple biomechanical studies have suggested that arthrodesis leads to increased loading of adjacent segments, which in turn leads to disk degeneration.1
In terms of cervical alignment, it is postu- lated that kyphotic angulation could potentially cause a shift of cervical loading from the poste- rior columns to the anterior column, in turn leading to unnatural loading of adjacent seg- ments.1 Recently, a systematic review of the literature was completed examining a possible correlation between cervical sagittal imbalance and adjacent segment pathology. It was de- termined that five poorquality retrospective studies demonstrated level III evidence of a correlation between cervical sagittal malalign- ment and adjacent segme
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Radiotherapy and Skin reaction
1. Effect of Ionizing Radiation on Skin
The Good, the Bad, and the Ugly
BOG July 2015
Dr. Lokesh Viswanath M.D.
Professor & Head of Unit
Department of Radiation Oncology
Kidwai Memorial Institute of Oncology
2. Radiation Induced skin reactions
• Domains
Radiation
Induced
Skin
Reactions
During
Radiation
Therapy : Acute
Effects and Late
effects
Accidental
exposures :
Industrial/
wartime
Nuclear
exposures /
Open isotopes
Radiation
Workers /
Public
exposure
monitoring
3. Introduction : Radiation induced skin toxicities
• ~ 95% of patients receiving RT for cancer
• negatively affect the quality of a patient's life :
pain and premature interruption of RT
• ranges in severity from mild erythema to moist
desquamation and ulceration.
• ionizing radiation damage is somewhat similar to
atopic dermatitis
• a common form of eczema
• ~20% of children
• profound effect on the stratum corneum function
• increased transepidermal water loss
4. History
• Skin burn attributed to radiation : 1901
• Skin erythema : Holzkencht`s
chromoradiometer 1902
5. Radiation skin injury
• morphological
• functional changes
• The degree of radiation injury »
– Total radiation dose, Dose /Fr
– proportion of body irradiated
– volume of tissues irradiated
– time interval of the radiation dose received
(Fr/week, No of Day, OTT)
6. most radiosensitive cells in the body
– high proliferative index
– Tissue oxygen
• The most radiosensitive organ systems are :-
– bone marrow
– reproductive and gastrointestinal systems
– Skin ←
– Muscle
– Brain
– etc
7. function of skin
• effective barrier against the surrounding environment
– Physical
– immunological
• The epidermis
– stratifying layers of keratinocytes
– primary barrier and biosensor
• The dermis
– provide structural strength
– connective tissue produced by dermal fibroblasts.
8. Skin is susceptible to radiation damage
• continuously renewing organ
• rapidly proliferating and maturing cells
• highly radiosensitive
– basal keratinocytes
– hair follicle stem cells
– melanocytes
• Radiation skin injury
– immediate damage to basal keratinocytes and hair follicle stem
cells
– Inflammation
– 1st keratinocytes
• disruption in the self-renewing property of the epidermis
• repeated exposures do not allow time for cells to repair tissue or DNA
damage.
• continually destroyed with each fraction
9. Radiation skin injury: categorized
• Acute injury : within hours to weeks
• late injury (i.e., chronic) : months to years after
radiation exposure
10. Acute radiation skin toxicty
• primarily involves cellular alterations and inflammation in the epidermis
and the dermis.
Acute changes
1. Erythema
2. Edema
3. pigment changes
4. Depilation
histological analysis:
• Hyper-proliferation of the epidermis
• thickening of the stratum corneum
• Trans-epidermal water loss – Significantly increased (a measure for skin
barrier integrity)
• Severe radiation injury
– complete loss of the epidermis
– persistent fibrinous exudates
– edema.
– Re-epithelialization begins within 10–14 days after radiation exposure in the
absence of infection
11. one year after radiation exposure
• skin
– thin
– Hypo-vascularized
– Tight
– susceptible to trauma or infection
• Chronic radiation skin injury
– delayed wound healing
– delayed ulcers
– Fibrosis
– telangiectasias
14. Pathophysiology
RT Skin Injury is different for thermal burn
1. dose-dependent clinical pattern, which includes
dry desquamation at 12–20 Gy, moist
desquamation at 20 Gy, and necrosis at >35 Gy
2. radiation Skin injury are associated with opiate-
resistant chronic pain
1. most complicating factor is the unpredictable
successive inflammatory waves occurring weeks to
years after radiation exposure
2. difficult to delineate the radiation-injured tissue from
noninjured tissue
3. healing of radiation skin lesion is extensive and
unpredictable.
15. Risk factors
• patient-related factors :
– obesity, age, gender, chronic sun exposure, and smoking
– Older female patients
– ataxia telangiectasia and hereditary nevoid basal cell
carcinoma syndrome (Gorlin Syndrome) require dose
alterations or avoidance of radiation exposure
• AT = mutations in the ATM gene, are highly susceptible to
severe radiation dermatitis
• GS: irradiation of individuals could produce widespread
cutaneous tumors.
• Other disorders :
– connective tissue disorders (lupus, scleroderma), chromosomal
breakage syndromes (Fanconi's anemia, Bloom syndrome),
xeroderma pigmentosa, Gardner's syndrome, hereditary malignant
melanoma, and dysplastic nevus syndrome
16. Risk Factor 2
• Technical factors :
– radiation dose to skin
– irradiation site :
• most sensitive - anterior of the neck, extremities, chest,
abdomen, and face , hair follicles on the scalp and breast tissue
– fractionation timing
– total exposure time
– angle of radiation beam
• Other risk factors
– increased transepidermal water loss
– infiltration of pathogens or bacteria into the skin
– Host antimicrobial defenses are severely compromised by
radiation and/or skin trauma combined with radiation
17. Late skin effect
Dose (Gy) Onset
Delayed
ulceration
>45
Weeks after
radiation
Dermal
necrosis/atrophy
>45
Months after
radiation
Fibrosis >45
6 Months to 1 year
after radiation
Telangiectasia >45
6 Months to 1 year
after radiation
18. Skin immune response following radiation
• skin provides : immune surveillance > maintains
homeostasis and is poised to respond to environmental
insults.
– Key cells : Langerhans cells (LCs)
– keratinocytes : important role because : producing large
amounts of cytokines, * IL-1α and tumor necrosis factor-α
• The LCs + dermal dendritic cells (DCs) = antigen-
presenting cells
– uptake of antigens that may breach the skin barrier
• The dermis : mast cells & T cells :> radiation-induced
immune response
20. • Keratinocytes, fibroblasts, and
endothelial cells in the skin
stimulate resident (i.e., LCs,
DCs, mast cells, T cells) and
circulating immune cells
• Numerous cytokines and
chemokines are produced in
response to these activation
signals, which act on the
endothelial cells of local
vessels, causing the
upregulation of adhesion
molecules
• Transendothelial migration of
immune cells, such as
neutrophils, macrophages, and
leukocytes, from circulation to
irradiated skin is considered a
“hallmark” of radiation-
induced skin injury
• Acute radiation skin toxicity
has been correlated with
increased formation of various
cytokines and chemokines,
most notably IL-1α, IL-1β,
tumor necrosis factor-α, IL-6,
IL-8, CCL4, CXCL10, and CCL2
22. acute radiation skin injury scoring systems
Score Observation
Radiation Therapy Oncology Group
0 No change over baseline
1 Erythema; dry desquamation; epilation
2 Bright erythema; moist desquamation; edema
3 Confluent moist desquamation; pitting edema
4 Ulceration, hemorrhage, necrosis
NIH CTCAE
0 None
1 Faint erythema or dry desquamation
2 Moderate to brisk erythema
3 Confluent moist desquamation
4 Skin necrosis or ulceration
Oncology Nursing Society
0 No change
1.0 Faint or dull erythema
1.5 Bright erythema
2.0 Dry desquamation with or without erythema
2.5
Small to moderate amount of moist
desquamation
3.0 Confluent moist desquamation
3.5 Ulceration, hemorrhage, or necrosis
23. Score Observation
Douglas & Fowler
0 Normal
0.25 50/50, Doubtful if any difference from normal
0.5 Very slight reddening
0.75 Definite but slight reddening
1 Severe reddening
1.25 Severe reddening with white scale; “papery” appearance of skin
1.5 Moist breakdown in one very small area with scaly or crusty appearance
1.75 Moist desquamation in more than one small area
2 Moist desquamation in 25% of irradiated area
2.25 Moist desquamtion in 33% of irradiated area
2.5 Moist desquamation in 50% of irradiated area
2.75 Moist desquamation in 66% of irradiated area
3 Moist desquamation in most of irradiated area
3.25 Moist desquamation in most of irradiated area with slight moist exudate
3.5 Moist desquamation in most of irradiated area with moist exudates; necrosis
Radiation dermatitis severity scale
0.0 Normal or none
0.5 Patchy faint/slight follicular eyrthema; faint hyperpigmentation
1.0 Faint and diffuse erythema; diffuse hyperpigmentation; mild epilation
1.5 Definite erythema; extreme darkening/hyperpigmentation
2.0 Definite erythema/hyperpigmentation with fine dry desquamation; mild edema
2.5 Definite erythema/hyperpigmentation with branny/scaly desquamation
3.0 Deep red erythema with diffuse dry desquamation; peeling in sheets
3.5
Violaceous erythema with early moist desquamation; peeling in sheets; patchy
crusting
4.0
Violaceous erythema with diffuse moist desquamation; patchy crusting; ulceration;
necrosis
24. Radiation Therapy Oncology Group : Late Skin
Toxicity Scoring
Onset Grade
0 1 2 3 4 5
Chronic None Slight
atrophy.
Patch
atrophy.
Moderate
telangiectasi
a. Total hair
loss.
Marked
atrophy.
Gross
telangiectasi
a.
Ucleration Death
26. management of radiation skin injury
• washing with mild soap (open isotopes)
• using unscented, lanolin-free, water-based moisturizing
cream,
• corticosteroid and nonsteroidal creams appeared to reduce
the severity of skin reactions, there was no clear indication of
a preferred topical agent.
• Amifostine and oral enzymes emerged as somewhat effective
preventative agents
• pentoxifylline reduced late, but not acute, effects of radiation
on the skin
• Long treatment (3 years) of pentoxifylline and tocopherol
(i.e., vitamin E) significantly reduced radiation-induced
fibrosis.
– Unfortunately, cessation of pentoxifylline–tocopherol treatment
before 3 years resulted in a “rebound effect” and more severe
radiation-induced fibrosis
27. radiation mitigators
• Targeted gene therapy
• potential targets:
– TGFβ1 pathway inhibitor synthetic superoxide dismutase
– catalase mimetics recombinant IL-12 toll-like receptor
– 5 agonist inhibitors of cyclin-dependent kinases
• pravastatin reduced radiation skin injury by maintaining endothelial cell
function after radiation exposure by increasing endothelial nitric oxide
synthase
• Curcumin, a component of turmeric, has also demonstrated the ability
to reduce radiation skin toxicity through its potent antioxidant and anti-
inflammatory activities
• acceleration of radiation delayed wound healing in mice upon
stimulation of TGFβ-1 and basic fibroblast growth factor, suggesting that
the growth factor treatment may mitigate radiation skin injury.
• Stem cell therapy combined with surgical excision has demonstrated
success in improving wound repair of severe radiation
• mesenchymal stem cell injections around the lesion at the cutaneous
and muscular levels, as well as in the bed of the lesion under the skin
graft
• adipose tissue–derived stem cells also promote wound healing in mice
31. Length of skin reaction (cms)
Length of skin reaction
(CMS)
Number
(n=23)
%
Up to 5 16 69.6
5-10 4 17.4
>10 3 13.0
Mean SD 5.48 4.07 cms
Up to 5
69.6%
5-10
17.4% >10
13.0%
Length of skin reaction (CMS)
AREA OF SKIN REACTION (Sq Cms)
AREA OF SKIN
REACTION (Sq Cms)
Number
(n=23)
%
Up to 10 12 52.2
11-20 6 26.1
>20 5 21.7
Mean SD 18.04 25.72 Sq cms
11-20
26.1%
>20
21.7%
Up to 10
52.2%
AREA OF SKIN REACTION (Sq Cms)
32.
33. Filgastrim Treatment Protocol
Step 1: Aseptic precautions were taken during the procedure – injection of a single
dose of 300 μg of Filgrastim was administered, subcutaneously in the
unirradiated normal skin around the periphery of the moist desquamation (2 or 4
quadrant zones).
Step 2: Proper wound care was advised – air drying and rest to the part of the body
that is affected for 2 to 3 days, mainly to prevent skin fold from rubbing against
the exposed skin and aggravating the lesion and to clothes from sticking to the
exposed skin wound.
Step 3: Sprinkling of Neosporin® – antibiotic powder (contains Neomycin &
Polymixin B sulfates & Bacitracin zinc) ever 6 hours was advised (instructions
were not to touch the exposed skin with cotton swab or apply ointments).
Step 4: Appropriate oral antibiotics (such as Amoxicillin & Cloxacillin for 7 days or
Ciprofloxacilllin with or without Tinidazole) when necessary were given to
patients
Step 5: Analgesic & anti inflammatory drugs: oral Ibuprofen if subject is symptomatic
for 1–2 days.
35. Number of Days required to Heal
No of Days required to
Heal
Superficial
epidermal
involvement
Deep Total
Up to 5 days 13 (76.5%) - 13(56.5%)
5-10 days 4 (23.5%) 3 (50.0%) 7 (30.4%)
>10 days - 3 (50.0%) 3 (13.0%)
Total 17 6 23
Mean SD
(Min-max)
4.53 2.07
(2-9)
12.66 5.12
(7-20)
6.65 4.73
(2-20)
76.5
0
23.5
50
0
50
0
5
10
15
20
25
30
35
40
45
50
55
60
65
70
75
80
Percentages
Up to 5 days 5-10 days >10 days
Sup.epdermal invol.
Deep
Number of days required to heal
36. Time to heal (Literature Review)
Time (days) Mean Authors
Duo Derm 4-6 4.6 Margolin et al 1990
G V paint 5 - 22 11
Hydrocortisone
Cream
21 - 28 Chen et al 1997
Gel Dressing 7 - 14
N. Saline 30 - 35
Dermofilm
dressing
11 - 16 See et al 1998
Inj GCSF s/c 2-20 6.65 Lokesh .V et al 2006
superficial 2-9 4.53
deep 7-20 12.66
37.
38. Female patient who completed 50Gy in 25 fractions radiotherapy for a Breast Cancer
presented with grade III moist dequmation in the Axillary fold (Superficial dermal
exposure) (1a). The patient was referred to us for cytokine therapy. The skin ulceration
healed in the next 4 days after GCSF injection (1b).
39.
40. • shows a 55year male who completed treatment with external
radiotherapy 5000cG in 25 fractions on Telcobalt Machine for
a head and neck malignancy developed grade 3 moist
desquamation of the skin (Deep skin lesions). The picture
shows an unresolved desquamation in spite of gentian violet
application.
• same patient with remarkable resolution of lesion by day 5.
He was able to reassume treatment within a week
41.
42.
43. a Female patient who completed radiotherapy 50Gy in 25 fractions 5 fractions per week, for Cancer Cervix. She presented with grade III moist
desquamation of the skin with deep dermal exposure. The patient was referred to us for cytokine therapy. Picture 2 a - Before cytokine
injection, Picture 2 b - day 2, Picture 2 c – day3 , Picture 2 d – day4, Picture 2 e – day 5 Shows Complete healing.
44. Summary
• there is no effective treatment to prevent or mitigate
radiation skin injury.
Simple solutions to prevent:
• No touch policy
• Megavoltage X Rays for RT
• Advanced Radiation techniqes : IMRT , Rotational
Modulated Arcs etc
• Use of multiple beams
• careful RT contouring & planning
• use of higher energies in obese patients
• Protons
• Amifostine