External irradiation of epithelial skin cancer

Lovett, Rosemary; Pérez, Carlos A.; Shapiro, Susan J.; Garcia, Delia M.

doi:10.1016/0360-3016(90)90529-s

Cited by 196 publications

(126 citation statements)

References 14 publications

(1 reference statement)

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“…The overall cure rate after X-ray therapy was consistent with published results, which range from 90% to 98% (Nevrkla and Newton, 1974;Orton, 1978, Reymann, 1980Dubin and Kopf, 1983;Fitzpatrick et al, 1984;Brady et al, 1987;Petrovich et al, 1987;Ashby et al, 1989;Mazeron et al, 1989;Rowe et al, 1989;Lovett et al, 1990;Wilder et al, 1991;Silverman et al, 1992b). More relapses occurred with brachytherapy in our study (8.8% failure rate at 4 years) than published in the literature, in which failure rates are less than 5% (Daly et al, 1984;Pierquin et al, 1987;Mazeron et al, 1989;Crook et al, 1990 (Chahbazian and Brown, 1980;Goldsmith and Sherwin, 1983;Brady et al, 1987;Pierquin et al, 1987;Mazeron et al, 1989;Morrison et al, 1993;Fleming et al, 1995).…”

Section: Failure Ratesupporting

confidence: 91%

“…This is in agreement with the rates published, which range from 2% to 5% (Nevrkla and Newton, 1974;Brady et al, 1987;Orton, 1978;Pierquin et al, 1987;Crook et al, 1990;Lovett et al, 1990;Lang and Maize, 1991;Wilder et al, 1991). The other major residual abnormalities were, as expected, dyspigmentations and telangiectasia.…”

Section: Failure Ratesupporting

confidence: 91%

“…The other major residual abnormalities were, as expected, dyspigmentations and telangiectasia. The rate of good cosmetic results appears to be lower than those published, but comparison was difficult because of the wide range of published rates of good aesthetic results (60-93%) assessed by patients or physicians (Chahbazian and Brown, 1980;Goldsmith and Sherwin, 1983;Brady et al, 1987;Pierquin et al, 1987;Mazeron et al, 1989;Crook et al, 1990;Lovett et al, 1990;Silverman et al, 1992b). The deterioration of the cosmetic appearance with time with radiotherapy confirms the previous results of Silverman (1992b) and the small study of Cooper (1988).…”

Section: Failure Ratesupporting

confidence: 50%

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Basal cell carcinoma of the face: surgery or radiotherapy? Results of a randomized study

Avril

Aupérin²,

Margulis³

et al. 1997

Br J Cancer

291

175

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Summary Basal cell carcinomas (BCCs) are very frequent cutaneous cancers, often located on the face. Cure rates with surgery and radiotherapy are high, but these treatments have never been compared prospectively. A randomized trial was initiated in 1982 to compare surgery and radiotherapy in the treatment of primary BCC of the face measuring less than 4 cm. The primary end point was the failure rate (persistent or recurrent disease) after 4 years of follow-up. The secondary end point was the cosmetic results assessed by the patient, the dermatologist and three persons not involved in the trial. In the course of the trial, 347 patients were treated. Of the 174 patients in the surgery group, 71% had local anaesthesia and 91% frozen section examination. Of the 173 patients in the radiotherapy group, 55% were treated with interstitial brachytherapy, 33% with contactherapy and 12% with conventional radiotherapy. The 4-year actuarial failure rate (95% Cl) was 0.7% (0.1-3.9%) in the surgery group compared with 7.5% (4.2-13.1%) in the radiotherapy group (log-rank P= 0.003). The cosmetic results assessed by four of the five judges were significantly better after surgery than after radiotherapy. Eighty-seven per cent of the surgery-treated patients and 69% of the radiation-treated patients considered the cosmetic result as good (P < 0.01). Thus, in the treatment of BCC of the face of less than 4 cm in diameter, surgery should be preferred to radiotherapy.

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Section: Failure Ratesupporting

confidence: 91%

Section: Failure Ratesupporting

confidence: 91%

Section: Failure Ratesupporting

confidence: 50%

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Basal cell carcinoma of the face: surgery or radiotherapy? Results of a randomized study

Avril

Aupérin²,

Margulis³

et al. 1997

Br J Cancer

291

175

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“…In radiation therapy, X‐rays or electron beams may be used to treat local skin cancers. A variety of radiation therapy techniques are used including superficial X‐rays, (4) orthovoltage X‐rays, (5) megavoltage photons, (4) electron beam therapy, (4) and brachytherapy 2 , 3 , 6 , 7 . Several groups have shown different percentages of tumor control results for nonmelanoma skin cancer treatment using superficial X‐rays with 93%–100%, (4) orthovoltage X‐rays with 87%, (8) electron beams with 72%–88%, (4) isotope‐based HDR brachytherapy with 92%–98%, (6) and 100% for eBT up to 2013 (6) …”

Section: Introductionmentioning

confidence: 99%

“…However, for a superficial X‐ray, dose falloff is exponential with the maximum dose being at the skin level. Generally for external electron beam therapy, a protocol with about 40 Gy to 60 Gy total dose is delivered at the rate of 2 Gy to 3 Gy per fractions within four to six weeks 4 , 6 . However, for brachytherapy, skin treatment by IR‐HDRs and eBT, the patient receives 6 to 8 fractions for a total dose ranging from 30 Gy to 40 Gy in two weeks 3 , 7 , 9 , 10 , 11 .…”

Section: Introductionmentioning

confidence: 99%

Optimum radiation source for radiation therapy of skin cancer

Safigholi

Song

Meigooni

2015

J Applied Clin Med Phys

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Several different applicators have been designed for treatment of skin cancers, such as scalp, hand, and legs using Ir‐192 HDR brachytherapy sources (IR‐HDRS), miniature electronic brachytherapy sources (eBT), and external electron beam radiation therapy (EEBRT). Although, all of these methodologies may deliver the desired radiation dose to the skin, but the dose to the underlying bone may become the limiting factor for selection of the optimum treatment technique. In this project, dose to the underlying bone has been evaluated as a function of the radiation type, thickness of the bone, and thickness of the soft tissue on top of bone, assuming the same radiation dose delivery to the skin. These evaluations are performed using Monte Carlo (MC) simulation technique with MCNP5 code. The results of these investigations indicate that, for delivery of the same skin dose with a 50 keV eBT, 4 MeV or 6 MeV EEBRT techniques, the average doses received by the underlying bones are 5.31, 2, or 1.75 times the dose received from IR‐HDRS technique, respectively. These investigations indicate that, for the treatment of skin cancer condition with bone immediately beneath skin, the eBT technique may not be the most suitable technique, as it may lead to excessive bone dose relative to IR‐HDRS and 6 MeV or 4 MeV electron beams.PACS number: 87.53.Jw, 87.55.K‐

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Recurrent Basal Cell Carcinoma Treated With Radiation Therapy

Wilder

Shimm²,

Kittelson³

et al. 1991

Arch Dermatol

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A retrospective study was performed of 61 recurrent basal cell carcinomas treated with radiation therapy between 1974 and 1990 at the University of Arizona College of Medicine or at Southwestern Radiation Oncology, Tucson, Arizona. The median length of follow-up was 57 months. Applying the American Joint Committee on Cancer staging system to these recurrent tumors, 36 were stage I, 19 were stage II, five were stage III, and one was stage IV. Kaplan-Meier methods were used to estimate the 5-year complete remission rates. The Mantel-Haenszel Test and the Cox Proportional Hazards Model were used to determine if tumor size, stage, histologic subtype, anatomic site, age, sex, dose, number of radiation therapy treatments, length of time over which the radiation therapy was administered, or type of radiation beam used (orthovoltage x-rays vs megavoltage electrons) affected the 5-year complete remission rates. Only tumor size and stage had a statistically significant effect on the complete remission rates. The Kaplan-Meier estimates of the 5-year complete remission rates for 0.5- to 1.0-cm tumors vs tumors larger than 1.0 cm were 96% (95% confidence interval, 88% to 100%) and 81% (95% confidence interval, 64% to 99%), respectively. The Kaplan-Meier estimates of the 5-year complete remission rates for stage I/II tumors vs stage III/IV tumors were 93% (95% confidence interval, 85% to 100%) and 42% (95% confidence interval, 8% to 84%), respectively. Functional and cosmetic results were frequently good to excellent at 5 years. Soft-tissue necrosis developed in two of 61 cases, and was successfully managed in both. This article, combined with a review of the literature, suggests that radiation therapy is an effective method of treating recurrent basal cell carcinomas.

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External irradiation of epithelial skin cancer

Cited by 196 publications

References 14 publications

Basal cell carcinoma of the face: surgery or radiotherapy? Results of a randomized study

Basal cell carcinoma of the face: surgery or radiotherapy? Results of a randomized study

Optimum radiation source for radiation therapy of skin cancer

Recurrent Basal Cell Carcinoma Treated With Radiation Therapy

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