Medical Radiology and Radiation Safety. 2015. Vol. 60. No. 1. P. 26-32

RADIATION BIOLOGY

I.A. Galstyan, N.M. Nadejina, M.G. Levadnaya, A.V. Aksenenko

Ulcer-Cancer of the Skin as an Outcome of Local Radiation Injury

Burnasyan Federal Medical Biophysical Center of FMBA, Moscow, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRACT

Purpose: To estimate the frequency and risk factors for malignancy of late radiation ulcers as an outcome of the local radiation injuries (LRI).

Material and methods: 217 cases of long-term supervisions on the wound process and late consequences of LRI developed owing acute accidental radiation exposure were analyzed. Four clinical supervisions of skin-cancer are described in details. The review of literature findings on the matter is provided.

Results: Cancer emergence in the area of existing late radiation ulcer is rare outcome of LRI after acute exposure and it is slightly more often at chronic radiation exposure. In Burnazyan FMBC archive there are data about 4 cases (1.8 %) of a cancer in the long existing radiation ulcers development. The average duration of existence of a late radiation ulcer until its malignancy 21.8 ± 3.2 (15-29) years with the average duration of supervision of patients of this whole group about 20 years. Average age of the patients at the moment of development of a neoplasma 60.8 ± 4.9 (48-69) years. As the main localization of LRI at contacts with the isolated sources of ionizing radiation are hands, in 3 of 4 cases the cancer was revealed on hands. Other localizations LRI to data of literature are rarer. Only one the cancer ulcer was found on a forward surface of a hip. Choice method for treatment of cancer ulcer is an active surgery. At our patients recurrence of the tumor wasn’t observed yet.

Conclusions: Possible outcome of late radiation ulcer is an ulcer cancer development. Frequency of a malignancy in the long existing late radiation ulcer 1.8 % that according to literature doesn’t exceed the frequency of tumor development in long existing nonradiation ulcer. This similarity is testified nonspecific pathogenetic mechanism related with vascular disturbances and insufficient immunological control in the LRI. Undoubtedly, the role of almost continuous local use of medicines, including possessing an irritant action is significant as well. Performed plastic surgery in the field of LRI could prevent a malignancy of ulcers and, thereby, improves quality of life and the life forecast.

Key words: local radiation injury, outcomes, late radiation ulcer, cancer, neoplasm

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For citation: Galstyan IA, Nadejina NM, Levadnaya MG, Aksenenko AV. Ulcer-Cancer of the Skin as an Outcome of Local Radiation Injury. Medical Radiology and Radiation Safety. 2015;60(1):26-32. Russian.

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