18845 Twelve-month local control and satisfaction results of selected patients with nonmelanoma skin cancer following outpatient superficial radiation therapy

Minka, E; Velasquez, Rosannah; Yu, Lio; Desai, Alpesh; Lin, Rick

doi:10.1016/j.jaad.2020.06.978

Cited by 4 publications

(2 citation statements)

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“…This technology offers patients a great benefit, especially when a patient is opting for non-surgical treatment of their NMSC lesion [ 18 ]. While this comparative study did not specifically analyze cosmesis, other US-SRT studies have shown cosmesis to be generally excellent without poor cosmetic outcomes prompting large portions of “repeat” US-SRT treatments at a later time [ 15 , 19 ]. An industry survey of patients post US-SRT treatment revealed that almost all patients (99%) noted they were happy with their decision and outcome (100%) and would recommend this non-surgical option (100%) [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Local control comparison of early-stage non-melanoma skin Cancer (NMSC) treated by superficial radiotherapy (SRT) and external beam radiotherapy (XRT) with and without dermal image guidance: a meta-analysis

Moloney

Tran

et al. 2022

Discov Onc

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Background Various treatments exist for non-melanoma skin cancer (NMSC), but the mainstay is surgical removal. Superficial radiotherapy (SRT) is one non-surgical technique that has been used for over a century but fell out of favor due to the advent of Mohs micrographic surgery (MMS). A new technology that combines a 22 megahertz (MHz) dermal ultrasound with SRT (US-SRT) enables tumor visualization before, during, and after treatment, and demonstrates increased cure rates and reduced recurrences. Methods We conducted a meta-analysis comparing the local control (LC) of four studies using traditional non-image-guided forms of radiotherapy for NMSC treatment to two seminal studies utilizing high-resolution dermal ultrasound-guided SRT (HRUS-SRT). The four traditional radiotherapy studies were obtained from a comprehensive literature search used in an article published by the American Society of Radiation Oncology (ASTRO) on curative radiation treatment of basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and squamous cell carcinoma in-situ (SCCIS) lesions. The meta-analysis employed a logit as the effect size indicator with Q-statistic to test the null hypothesis. Results LC rates for the 2 US-SRT studies were statistically superior to the 4 traditional therapies individually and collectively. When stratified by histology, statistically superior outcomes for US-SRT were observed in all subtypes with p-values ranging from p < 0.0001 to p = 0.0438. These results validated an earlier analysis using a logistic regression statistical method showing the same results. Conclusion US-SRT is statistically superior to non-image-guided radiotherapies for NMSC treatment. This modality may represent the future standard of non-surgical treatment for early-stage NMSC.

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Section: Discussionmentioning

confidence: 99%

Local control comparison of early-stage non-melanoma skin Cancer (NMSC) treated by superficial radiotherapy (SRT) and external beam radiotherapy (XRT) with and without dermal image guidance: a meta-analysis

Moloney

Tran

et al. 2022

Discov Onc

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“…Patients experience excellent outcomes when their early-stage NMSCs are treated by IGSRT. Specifically, the minimal side effects and high satisfaction scores 16 associated with the standard dosing regimen of IGSRT and the very low 2-year freedom from recurrence rates of NMSCs treated by this modality. Taken together, these data indicate that IGSRT is a critical technilogical step forward providing modern, MMS-scale local control of NMSCs with a very tolerable toxicity profile.…”

Section: Discussionmentioning

confidence: 99%

Image guidance improves freedom from recurrence in superficial radiation therapy for non-melanoma skin cancer

McClure

Sedor

Moloney

et al. 2022

Preprint

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Importance: This is the first study to quantify the 2-year recurrence rate of non-melanoma skin cancers (NMSCs) treated with image-guided superficial radiation therapy (IGSRT) and compare it to existing data on SRT, which is key to demonstrating the efficacy of IGSRT. Objective: To quantify the 2-year recurrence rate for individuals with basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and squamous carcinoma in-situ (SCCIS) treated with IGSRT versus SRT without image guidance. Design: A retrospective cohort study that collected data from a standardized electronic medical record (Modernizing Medicine - EMA), written radiation treatment records, and record/verify system (Sensus Healthcare - Sentinel) to evaluate the 2-year recurrence rate of NMSCs treated by IGSRT (March 2016 to January 2022) and compare it to existing data on NMSCs treated by SRT via one sample proportion tests. Setting: Multi-institution outpatient dermatology practices. Participants: Individuals > 18 years old with biopsy-proven SCC, SCCIS, and/or BCC treated with IGSRT. 1602 patients with a total of 2,880 treated lesions were followed until 1/14/2022. As of that date, 22 lesions had recurred, and 2858 lesions were still at risk for recurrence. An 18-month cutoff for recency of assessment was utilized, resulting in 1204 lesions (41.8%) that were lost to follow-up. Exposure: Treatment with IGSRT or SRT. Main Outcomes: The overall 2-year recurrence probability of 2880 NMSCs treated by IGSRT was 0.7%, which is statistically significantly lower than two previously reported SRT studies (p < 0.001). Results: All NMSCs (SCC, SCCIS, BCC) treated by IGSRT in this cohort had an aggregate 2-year freedom from recurrence of 99.23%. When stratified by NMSC histologic type, the recurrence rate for BCC was 1.1% (N=1382), for SCC 0.8% (N=904) and for SCC 0.0% (N=594). These rates of recurrence are significantly improved compared to a pooled study that evaluated NMSCs across histology (Cognetta) and BCCs alone (Silverman) treated without image guidance (standard SRT) (p < 0.001). Conclusions and relevance: Image-guided superficial radiation (IGSRT) therapy offers a paradigm-shifting treatment option for patients with NMSCs - offering statistically significantly improved outcomes compared to standard SRT, and a more desirable toxicity profile to surgical options. This study demonstrates that this treatment modality is associated with remarkably low recurrence rates, which are statistically significantly improved from the previous generation of SRT, and in line with modern outcomes for Mohs micrographic surgery, though a head-to-head comparison has yet to be performed.

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Image-Guided Superficial Radiotherapy and Other Noninvasive Modalities Used in the Treatment of Non-melanoma Skin Cancer and Keloids

Yu,

Moloney,

Bard

2023

Image-Guided Aesthetic Treatments

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18845 Twelve-month local control and satisfaction results of selected patients with nonmelanoma skin cancer following outpatient superficial radiation therapy

Cited by 4 publications

References 0 publications

Local control comparison of early-stage non-melanoma skin Cancer (NMSC) treated by superficial radiotherapy (SRT) and external beam radiotherapy (XRT) with and without dermal image guidance: a meta-analysis

Local control comparison of early-stage non-melanoma skin Cancer (NMSC) treated by superficial radiotherapy (SRT) and external beam radiotherapy (XRT) with and without dermal image guidance: a meta-analysis

Image guidance improves freedom from recurrence in superficial radiation therapy for non-melanoma skin cancer

Image-Guided Superficial Radiotherapy and Other Noninvasive Modalities Used in the Treatment of Non-melanoma Skin Cancer and Keloids

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