The Impact of Socioeconomic Status and Comorbidities on Non-Melanoma Skin Cancer Recurrence After Image-Guided Superficial Radiation Therapy.

IF 4.4 2区医学 Q1 ONCOLOGY Cancers Pub Date : 2024-12-01 DOI:10.3390/cancers16234037

Liqiao Ma, Michael Digby, Kevin Wright, Marguerite A Germain, Erin M McClure, Francisca Kartono, Syed Rahman, Scott D Friedman, Candace Osborne, Alpesh Desai

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Abstract

Background: Non-melanoma skin cancers (NMSCs) are the most common cancers in the United States. Image-guided superficial radiation therapy (IGSRT) is an effective treatment for NMSCs. Patient comorbidities and socioeconomic status (SES) are known contributors to health disparities. However, the impact of comorbidities or SES on the outcomes of IGSRT-treated NMSCs has not yet been studied. This study evaluated freedom from recurrence in IGSRT-treated NMSCs stratified by SES and the number of comorbidities.

Methods: This large retrospective cohort study evaluated associations between SES (via Area Deprivation Index (ADI)) or comorbidity (via Charlson Comorbidity Index (CCI)) and 2-, 4-, and 6-year year freedom from recurrence in patients with IGSRT-treated NMSC (n = 19,988 lesions).

Results: Freedom from recurrence in less (ADI ≤ 50) vs. more (ADI > 50) deprived neighborhoods was 99.47% vs. 99.61% at 6 years, respectively (p = 0.2). Freedom from recurrence in patients with a CCI of 0 (low comorbidity burden) vs. a CCI of ≥7 (high comorbidity burden) was 99.67% vs. 99.27% at 6 years, respectively (p = 0.9).

Conclusions: This study demonstrates that there are no significant effects of SES or comorbidity burden on freedom from recurrence in patients with IGSRT-treated NMSC. This supports the expansion of IGSRT in deprived neighborhoods to increase access to care, and IGSRT should be a consideration even in patients with a complex comorbidity status.

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社会经济地位和合并症对非黑色素瘤皮肤癌图像引导表层放射治疗后复发的影响

背景：非黑色素瘤皮肤癌（NMSCs）是美国最常见的癌症。图像引导浅表放射治疗（IGSRT）是治疗神经间充质干细胞的有效方法。患者合并症和社会经济地位（SES）是造成健康差异的已知因素。然而，合并症或SES对igsrt治疗的NMSCs结果的影响尚未得到研究。本研究评估了按SES分层的igsrt治疗的NMSCs的复发自由和合并症的数量。方法：这项大型回顾性队列研究评估了接受igsrt治疗的NMSC患者（n = 19,988个病变）的SES（通过面积剥夺指数（ADI））或合并症（通过Charlson合并症指数（CCI））与2、4和6年复发自由度之间的关系。结果：6年时，较少（ADI≤50）和较多（ADI≤50）贫困社区的复发自由分别为99.47%和99.61% （p = 0.2）。CCI为0（低合并症负担）和CCI≥7（高合并症负担）的患者6年复发率分别为99.67%和99.27% （p = 0.9）。结论：本研究表明，SES或合并症负担对igsrt治疗的NMSC患者的复发无显著影响。这支持在贫困社区扩大IGSRT以增加获得护理的机会，即使在患有复杂合并症的患者中也应考虑IGSRT。

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来源期刊

Cancers Medicine-Oncology

CiteScore

8.00

自引率

9.60%

发文量

5371

审稿时长

18.07 days

期刊介绍： Cancers (ISSN 2072-6694) is an international, peer-reviewed open access journal on oncology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.