Circumferential volumetric modulated arc radiotherapy of the lower legs–a technique described in a case of disseminated superficial actinic porokeratosis

Abstract

A case of a fit 65-year-old male with a long history of recalcitrant Disseminated Superficial Actinic Porokeratosis (DSAP) treated with Volumetric Modulated Arc Radiotherapy (VMAT) is presented. The whole circumference of both lower legs from knees to ankles were simultaneously treated to 43.2 Gray (Gy) in 24 fractions, one fraction short of the prescription dose of 45 Gy in 25 fractions. There was in-field clearance of DSAP at ten weeks. This is the first publication of circumferential VMAT treatment of the skin of the lower legs. More follow up is required to see the durability of control of DSAP, and more research is needed to test the generalisability of this technique.