浅表放疗:高度选择的皮肤癌患者基底细胞癌和鳞状细胞癌的长期随访

Simon J. Madorsky, Orr A. Meltzer, A. Miller
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摘要

据报道,浅表放疗(SRT)治疗非黑色素瘤皮肤癌的治愈率不同。当患者选择性高,选择足够的治疗范围,并避免低分割时,SRT的治愈率可接近Mohs手术。本研究的目的是评估我们中心的SRT选择标准的长期结果,确定最佳治疗候选人的适当决策参数,并回顾文献。对2012-2018年所有SRT病例进行回顾性图表分析。确定肿瘤的位置、大小、类型和深度。记录了处理能量、分馏和辐射场大小。分析复发情况及并发症。在131个治疗的病变中,头颈部病变(105.80%)是最常见的部位,主要在下鼻(60.46%)。122例复发病灶中,2例(1.6%)复发,平均随访时间5年。急性溃疡发生在头颈部病变29例(28%),躯干病变5例(63%),腿部病变9例(50%)。5例(28%)腿部病变发生迟发性溃疡。综上所述,当患者经过精心挑选时,SRT的长期治愈率可达98%。
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Superficial Radiotherapy: Long Term Follow-Up of Highly Selected Basal and Squamous Cell Carcinomas in Skin Cancer Patients
Superficial radiotherapy (SRT) treatment for non-melanoma skin cancer has been reported to yield variable cure rates. When patients are highly selected, adequate margins of treatment are chosen, and hypofractionation is avoided, cure rates of SRT can approach that of Mohs surgery. The objective of this study is to evaluate long term results of our center’s SRT selection criteria and define proper decision-making parameters of optimal candidates for treatment, and to review the literature. A retrospective chart analysis was done of all SRT cases from 2012-2018. Location, size, type and depth of the treated tumors were defined. Treatment energy, fractionation, and radiation field size were documented. Recurrences and complications were analyzed. Of 131 treated lesions treated, head and neck lesions (105, 80%) were the most common location, primarily on the lower nose (60, 46%). Of 122 lesions analyzed for recurrence, 2 (1.6%) recurred, with a mean follow-up time of 5 years. Acute ulcerations in 29 (28%) head and neck lesions, 5 (63%) trunk lesions, and 9 (50%) leg lesions occurred. Delayed ulcerations occurred in 5 (28%) leg lesions. In conclusion, when patients are highly selected, long-term SRT cure rates up to 98% can be achieved.
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