Edema management with compression therapy during volumetric modulated arc therapy for extensive skin field cancerisation – a case study

March 17, 2022 Radiology & Cancer Therapy No Comments

Non-melanoma skin cancer is the most frequently diagnosed cancer in Australia. Recent
advances in radiation therapy (RT) allow large convex areas with extensive skin field
cancerisation (ESFC) to be treated using volumetric modulated arc therapy (VMAT). RT
doses and volumes are planned by radiation oncologists from pre-treatment computed
tomography (CT) scans. Changes in limb volume due to the inflammatory response
triggered by radiation can affect planned volumes and result in inaccuracies in dosimetry.
We present a case study comparing outcomes with and without compression therapy
following wide field VMAT to bilateral lower limbs. As edema can affect dosimetry, we
hypothesized that edema management using compression therapy would be beneficial in
controlling acute edema during RT. In this case when compression was applied during RT,
treatment was able to be completed as planned in comparison to RT without compression
where additional breaks in treatment were required due to edema and pain. There has been
little published research examining edema management during RT for wide field skin
cancerisation, however this case suggests further investigation is warranted to examine the
potential value of compression therapy and accurate objective measures during VMAT for
ESFC.

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