Book contents
- Frontmatter
- Contents
- List of Contributors
- Foreword by Daniel R. Salomon
- Foreword by Robin Marks
- Foreword by Kathy Schwab
- Preface
- Acknowledgments
- SECTION ONE TRANSPLANT DERMATOLOGY: AN EVOLVING DYNAMIC FIELD
- Section Two Transplant Medicine and Dermatology
- Section Three Pathogenic Factors in Transplant Dermatology
- Section Four Cutaneous Effects of Immunosuppressive Medications
- Section Five Infectious Diseases of the Skin in Transplant Dermatology
- Section Six Benign and Inflammatory Skin Diseases in Transplant Dermatology
- Section Seven Cutaneous Oncology in Transplant Dermatology
- Section Eight Special Scenarios in Transplant Cutaneous Oncology
- 32 Metastatic Squamous Cell Carcinoma in Organ Transplant Recipients
- 33 In-Transit Metastatic Squamous Cell Carcinoma in Organ Transplant Recipients
- 34 Metastatic Malignant Melanoma in Organ Transplant Recipients
- 35 Transplant Scalp: Severe Actinic Damage of the Scalp in Organ Transplant Recipients
- 36 Transplant Lip: Severe Actinic Damage of the Vermilion in Organ Transplant Recipients
- 37 Transplant Hands: Severe Actinic Damage of the Hands in Organ Transplant Recipients
- 38 Skin Cancer and Nevi in Pediatric Organ Transplant Recipients
- 39 Dermatologic Surgery in Organ Transplant Recipients
- 40 Radiation Therapy in Organ Transplant Recipients
- 41 Reduction of Immunosuppression for Transplant-Associated Skin Cancer
- 42 Systemic Retinoids for Prevention of Skin Cancer in Organ Transplant Recipients
- 43 Topical Treatment of Actinic Keratosis and Photodamage in Organ Transplant Recipients
- 44 Imiquimod Use in Organ Transplant Recipients
- 45 Photodynamic Therapy in Organ Transplant Recipients
- 46 Skin Cancer Prevention and Photoprotection in Organ Transplant Recipients
- 47 Skin Cancer Prior to Organ Transplantation or Organ Donation
- Section Nine Educational, Organizational, and Research Efforts in Transplant Dermatology
- Index
40 - Radiation Therapy in Organ Transplant Recipients
from Section Eight - Special Scenarios in Transplant Cutaneous Oncology
Published online by Cambridge University Press: 18 January 2010
- Frontmatter
- Contents
- List of Contributors
- Foreword by Daniel R. Salomon
- Foreword by Robin Marks
- Foreword by Kathy Schwab
- Preface
- Acknowledgments
- SECTION ONE TRANSPLANT DERMATOLOGY: AN EVOLVING DYNAMIC FIELD
- Section Two Transplant Medicine and Dermatology
- Section Three Pathogenic Factors in Transplant Dermatology
- Section Four Cutaneous Effects of Immunosuppressive Medications
- Section Five Infectious Diseases of the Skin in Transplant Dermatology
- Section Six Benign and Inflammatory Skin Diseases in Transplant Dermatology
- Section Seven Cutaneous Oncology in Transplant Dermatology
- Section Eight Special Scenarios in Transplant Cutaneous Oncology
- 32 Metastatic Squamous Cell Carcinoma in Organ Transplant Recipients
- 33 In-Transit Metastatic Squamous Cell Carcinoma in Organ Transplant Recipients
- 34 Metastatic Malignant Melanoma in Organ Transplant Recipients
- 35 Transplant Scalp: Severe Actinic Damage of the Scalp in Organ Transplant Recipients
- 36 Transplant Lip: Severe Actinic Damage of the Vermilion in Organ Transplant Recipients
- 37 Transplant Hands: Severe Actinic Damage of the Hands in Organ Transplant Recipients
- 38 Skin Cancer and Nevi in Pediatric Organ Transplant Recipients
- 39 Dermatologic Surgery in Organ Transplant Recipients
- 40 Radiation Therapy in Organ Transplant Recipients
- 41 Reduction of Immunosuppression for Transplant-Associated Skin Cancer
- 42 Systemic Retinoids for Prevention of Skin Cancer in Organ Transplant Recipients
- 43 Topical Treatment of Actinic Keratosis and Photodamage in Organ Transplant Recipients
- 44 Imiquimod Use in Organ Transplant Recipients
- 45 Photodynamic Therapy in Organ Transplant Recipients
- 46 Skin Cancer Prevention and Photoprotection in Organ Transplant Recipients
- 47 Skin Cancer Prior to Organ Transplantation or Organ Donation
- Section Nine Educational, Organizational, and Research Efforts in Transplant Dermatology
- Index
Summary
INTRODUCTION
Nonmelanoma skin cancer (NMSC) is the most common malignancy worldwide. Most lesions (80–90%) arise on the sun-exposed head and neck in middle-aged to elderly fair-skinned people. In the nontransplant, or immunocompetent population, basal cell carcinoma (BCC) occurs more often than squamous cell carcinoma (SCC). However, organ transplant recipients (OTR) experience not only a markedly higher incidence NMSC compared to the general population but also a much higher incidence of SCC compared to BCC. OTR developing NMSC are often younger (<50 years old) and may experience multiple primary NMSC. In addition to occurring on the head and neck, NMSC in OTR also arise on the sun-exposed extremities especially the arms and dorsal hands. A subset of OTR develop aggressive and potentially life threatening skin malignancies (usually SCC) secondary to immunosuppression. Other less common, but also potentially aggressive cutaneous malignancies encountered in OTR are listed in Table 40.1.
Radiotherapy (RTx) is an important modality in treating patients with cutaneous malignancies. The general principles for recommending RTx apply equally to OTR and immunocompetent patients; however, an immunosuppressed state must be factored in to any management decision, particularly in the adjuvant (postoperative) setting, where recurrent (local or nodal) disease may be life threatening.
The recommendation of definitive RTx, defined as primary RTx as a therapeutic modality instead of surgery, may be made when the outcome (cosmetic and/or functional) is considered better with RTx than with surgery, especially when a clinician constrained by the site or size of the lesion.
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- Information
- Skin Disease in Organ Transplantation , pp. 254 - 261Publisher: Cambridge University PressPrint publication year: 2008