Short-Course Radiotherapy in Elderly Patients with Early Stage Non-Melanoma Skin Cancer: A Phase II Study

Ferro, M.; Deodato, Francesco; Macchia, G.; Gentileschi, Stefano; Cilla, Savino; Torre, G La; Padula, Gilbert D. A.; Nuzzo, M.; Massaccesi, Mariangela; Valentini, Vincenzo; Morganti, Alessio Giuseppe

doi:10.3109/07357907.2014.998835

Cited by 35 publications

(39 citation statements)

References 17 publications

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“…A thorough literature search (Fig. ) retrieved 40 relevant publications from 1983 to 2017 that fulfilled our inclusion criteria . Reported data pertaining to patient, tumour, RT and follow‐up are outlined in Table and .…”

Section: Resultsmentioning

confidence: 99%

“…In total, 12,337 irradiated lesions were accounted for across the 40 included publications . Thirty‐nine studies documented a mean of 272.2 patients per report . Twenty‐nine publications noted patient gender and a male predilection (54.5%) was demonstrated .…”

Section: Resultsmentioning

confidence: 99%

“…Twenty‐nine publications noted patient gender and a male predilection (54.5%) was demonstrated . Twenty‐nine studies recorded median (or mean) age which exceeded 70 years, in all but five reports . Weighted‐mean age was calculated to be 71.73 years from 15 publications and 4852 patients .…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of hypofractionated radiotherapy in patients with non‐melanoma skin cancer: Results of a systematic review

Gunaratne

Veness

2018

J Med Imag Rad Onc

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Radiation oncologists are increasingly tasked with the management of elderly patients with non-melanoma skin cancer, unsuitable for surgical intervention due to inoperable lesions and/or poor performance status. In this cohort, hypofractionated radiotherapy, delivered either daily, alternative daily or once weekly is highly effective. A systematic literature search was conducted of PUBMED, MEDLINE and EMBASE databases using the algorithm ('radiotherapy' OR 'radiation therapy' OR 'brachytherapy') AND ('hypofraction' OR 'hypofractionated' OR 'hypofractionation') AND ('skin neoplasms' OR 'carcinoma' OR 'malignancy') AND ('skin' OR 'epidermis' OR 'epidermal' OR 'cutaneous'). Forty relevant publications (1983-2017) encompassing 12,337 irradiated lesions were retrieved. Studies documented a mean age of 71.73 years and male predilection (54.5%). Both external beam radiotherapy and brachytherapy were utilized. Tumour subtype was squamous cell carcinoma (23.5%), basal cell carcinoma (75.2%) or others (1.3%). Irradiated lesions were primary (or denovo) (92.6%), located on the head and neck (95.7%) and received definitive therapy (96.5%). Analysis demonstrated a mean weighted total radiotherapy dose (38.15 Gy), dose per fraction (7.95 Gy) and treatments per week (2.98). Despite significant heterogeneity in the study population, the radiotherapy delivered and follow-up, local recurrence rate (crude or Kaplan-Meier analysis) did not exceed 7.9% in all but three of the 36 publications providing these data. Twenty-nine publications documented local control exceeding 90%. There is a body of evidence documenting the efficacy of hypofractionated radiotherapy as an option that confers no obvious disadvantage in local control when compared to traditional more protracted radiotherapy schedules.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Efficacy of hypofractionated radiotherapy in patients with non‐melanoma skin cancer: Results of a systematic review

Gunaratne

Veness

2018

J Med Imag Rad Onc

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“…For BCC, there is data to support reduced rates of local failure with higher dose-per-fraction [6,7] and hypofractionated therapy with electron beam RT was shown to have good local control and acceptable cosmesis [9]. A recent phase-II trial illustrated >90 % local control treating BCC and SCC in elderly patients with a schedule of 30 Gy in 6 fractions of 5 Gy [45]. Considerations when deciding on fractionation should include tumor factors, such as site, stage, and histology, as well as patient factors, like cosmesis and patient preference.…”

Section: Radiotherapy Treatment Of Bccmentioning

confidence: 97%

“…Many dose-fractionation schedules have been described for treatment of BCC and SCC [13], but there is no consensus [45]. For BCC, there is data to support reduced rates of local failure with higher dose-per-fraction [6,7] and hypofractionated therapy with electron beam RT was shown to have good local control and acceptable cosmesis [9].…”

Section: Radiotherapy Treatment Of Bccmentioning

confidence: 98%

Treatment of Non-Melanomatous Skin Cancer with Radiotherapy

et al. 2015

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Non-melanomatous skin cancer (NMSC) is the leading cause of cancer in the United States. Treatment with surgical excision is considered the gold standard, but radiotherapy is an excellent alternative to surgical excision. Radiotherapy for NMSC takes many forms including a variety of external beam treatments as well as brachytherapy. Radiotherapy is indicated in a broad range of patients and is particularly useful in elderly patients who are poor surgical candidates or prefer not to have surgery. Radiotherapy is also employed in certain cases of recurrence and perineural invasion and when margin control is a concern. In addition to discussing standard techniques and indications for radiotherapy, this article will review specific considerations for radiotherapy in the treatment of basal cell carcinoma and squamous cell carcinoma. Finally, the article will examine new developments in the treatment of NMSC with radiotherapy including electronic brachytherapy and Helical TomoTherapy.

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SPECT/CT and fusion ultrasound to target the efferent groin lymph node for lymphatic surgery

et al. 2019

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Introduction: Pelvic lymphadenectomy (PL) causes changes to the inguinal lymph nodes with progressive loss of immune and lymphatic pump function. Efferent lymphatic vessel-to-venous anastomosis (ELVA) has been reported to address this problem. The aim of this report was to describe the feasibility of the SPECT/CT combined with ultrasound fusion imaging (UFI) to target the groin efferent lymph node (GELN) for ELVA.Patients and Methods: Twelve patients with lower limb lymphedema after PL were scheduled for peripheric lymphaticovenular anastomosis (LVA) combined with ELVA.All-patients were clinically ISL-stage1, with good visualization of the inguinal lymph nodes at preoperative lymphoscintigraphy. The mean patient age was 55.4 years and the mean BMI was 25.5.The mean limb circumference (MLC) was calculated before surgery and 1 year after surgery. The LymQoL-Leg questionnaire was administered before surgery and 6 months after surgery. Before surgery, the GELN was identified by SPECT/CT and its location was marked on the skin by UFI virtual navigation. Peripheric LVA sites were planned by ultrasound and indocyanine green (ICG) lymphography. Pre and postoperative MLC and LymQoL-Leg scores were compared.Results: In all-patients, the SPECT/CT succeeded at detecting and targeting the GELN. In all-patients, real-time anatomical coregistration with US was feasible, and it was possible to mark on the groin skin the depth and position of the GELN on the skin at the groin. During surgery, in every patient, we found the GELN marked before surgery and performed ELVA. We also performed two or three peripheric LVAs in every patient. The mean value of MLC decreased (38.2 ± 2.13 cm vs. 36.33 ± 2.14 cm; p = .04) and the mean score of the LymQoL-Leg questionnaire improved (9.3 ± 1.7 vs. 7.7 ± 1.1; p = .02).Conclusion: SPECT/CT combined with UFI is feasible for the preoperative identification of GELN for ELVA.

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Short-Course Radiotherapy in Elderly Patients with Early Stage Non-Melanoma Skin Cancer: A Phase II Study

Abstract: Short-course RT in elderly NMSC patients produces >90% local control of disease.

Cited by 35 publications

References 17 publications

Efficacy of hypofractionated radiotherapy in patients with non‐melanoma skin cancer: Results of a systematic review

Efficacy of hypofractionated radiotherapy in patients with non‐melanoma skin cancer: Results of a systematic review

Treatment of Non-Melanomatous Skin Cancer with Radiotherapy

SPECT/CT and fusion ultrasound to target the efferent groin lymph node for lymphatic surgery

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