Radiotherapy for Hidradenitis Suppurativa: A Systematic Review

Thompson, Alexander; Seivright, Justine; Atluri, Swetha; Ederle, Amanda; Jaros, Joanna; Hsiao, Jennifer L.; Shi, Vivian Y.

doi:10.1159/000514027

Cited by 7 publications

(9 citation statements)

References 22 publications

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“…Recently, successful use of modern radiation equipment such as brachytherapy and electron-beam irradation was described in two case reports with severe, longstanding HS [36,37]. However, also concerning modern RT techniques for HS, there is lack of studies with regard to patient selection, dose regime, and risk of induced cancer [9,33,34].…”

Section: Discussionmentioning

confidence: 99%

“…Low-dose RT for HS, however, is associated with only mild short-term side effects. Occasionally, there may be temporary epilation [9][10][11]. This has been referred to as hair follicle destruction [18], but this seems a misinterpretation, because the hairs return within 2-3 months [18] [18].…”

Section: Discussionmentioning

confidence: 99%

“…The reported results, publication bias taken into consideration, have been encouraging. In several HS case series the therapeutic results ranged from marked improvement to complete resolution of symptoms [4,[7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Follow-Up after Radiotherapy of Hidradenitis Suppurativa

Boer¹

2021

Dermatology

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Background: Patients with hidradenitis suppurativa (HS) are still often disappointed with the current treatments offered and there is a clear demand for more effective options. Since the late 1990s there has been a revival in the use of radiotherapy (RT) for different benign diseases, including HS. During the past 20 years one case series and some scattered case reports have described promising results of RT. Objectives: To evaluate the long-term efficacy of RT in early-stage HS. Methods: A postal survey-based long-term follow-up with simple factual questions of partly retrospective and partly contemporary characteristics was performed. Sixty-four patients (96 axillae), diagnosed with mild to moderate HS were irradiated with a orthovoltage unit with 100 kV, 3 mm Al or 200 kV, 0.5 Cu filtering, respectively. Four to six biweekly fractional doses ranging from 0.75 to 1 Gy up to a total dose of 6 Gy in one series, and in chronic cases followed by four daily fractions of 2 Gy up to a total dose of 14 Gy, were given. Late treatment toxicity and the rate of remission of the disease were evaluated. Results: The overall response rate of the survey was 64.1% with 40.6% (26/64) valid, complete questionnaires. In total, 40 axillae were irradiated in these 26 patients. After a median follow-up of 40 years (range 32–52) complete remission of the lesions occurred in 34 of the 40 sites (85%). None of the 26 patients with 40 irradiated sites reported adverse effects at the time of the survey. Conclusions: RT appears to be an effective treatment for early and mild HS in the majority of patients. In this case series, no side effects were reported after a median follow-up period of 40 years.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Long-Term Follow-Up after Radiotherapy of Hidradenitis Suppurativa

Boer¹

2021

Dermatology

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“…25 Suffice to say that the quality of the data used to establish the guidelines, especially the Australian contribution, could be better. 7,8 Radiation effects on benign diseases of skin: RT has been shown to have efficacy in benign disease such as rosacea, 26 psoriasis, 27 hidradenitis suppurativa, 28 disseminated superficial actinic porokeratosis, 29 extramammary Paget's disease, 30 PTEN hamartomatous disease, 31 and keloids. 32 These diseases have something in common with malignant disease in that they share a rapidly dividing cell population (Figure 17).…”

Section: Does the Problem Of Accelerated Repopulation Occur In Skinmentioning

confidence: 99%

A scientific approach to skin radiotherapy nursing Article 2 - The anatomy, physiology, pathology and radiobiology of skin and its diseases

Fogarty¹,

Mallon²,

Athar³

et al. 2022

IJRRT

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Nurses play an important role in the care of patients treated with radiotherapy (RT) for skin conditions such as skin cancers. A series of four articles will aim to supplement general oncology nurse training by providing a scientific basis to better understand the skin and its diseases, the use of RT in skin, and the management of necessary acute skin RT reactions to achieve best patient outcomes. The first article focused on the role of the nurse within the radiation oncology department and the initial patient assessment. This second article describes the anatomy, physiology, pathology and radiobiology of skin and its diseases. These concepts are fundamental to the understanding of how acute effects develop during treatment and how to best care for them. The transition time of normal keratinocytes in the epidermis from creation to demise (10-14 days) is discussed as essential to understanding the timing of acute RT effects. The effect of RT on DNA, and the different effects of RT on normal cells versus tumour cells, which underscore fractionation and normal tissue conservation, are also discussed. Finally, this article addresses the late effects of RT in normal skin, accelerated repopulation, types of skin cancers and their relative radiosensitivities, and the effects of RT on benign skin diseases. The third article will describe the skin RT prescription and plan, especially in relation to volume and dose; and the fourth will show how the nurse, by applying the knowledge from the previous articles, can predict, explain and care for the acute side effects that may arise during a course of skin radiotherapy.

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“…The indications for RT in benign disease such as keloids, 21 rosacea, 9 psoriasis, 10 hidradenitis suppurativa; 22 and in-situ disease, such as extramammary Paget's disease 23 and extensive skin field cancerisation, 24 are growing. These patients may have different expectations, especially about survival, from those receiving RT for non-skin invasive cancers like breast and prostate cancers.…”

Section: Treatment For Benign Disease and In Situ Diseasementioning

confidence: 99%

A scientific approach to skin radiotherapy nursing Article 1 - The role of the nurse in patient assessment

Fogarty¹,

Sutton²,

Christiansen³

et al. 2022

IJRRT

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Nurses play an important role in the care of patients treated with radiotherapy (RT) for skin conditions, such as skin cancers. A series of four articles will aim to supplement general oncology nurse training by providing a scientific basis to better understand the skin and its diseases, the use of RT in skin, and the management of necessary acute skin RT reactions to achieve best patient outcomes. This first article focuses on the role of the nurse within the radiation oncology department and the initial patient assessment. It enables the nurse to develop an appreciation of the unique nature of patients undergoing RT to the skin and provides recommendations on nursing assessment, patient examination, and optimal care of the skin RT patient. It also highlights the psychological impact of a skin cancer diagnosis on the patient. The second article in this series of four revises the anatomy, physiology, pathologies and radiobiology of skin. The third describes the skin RT prescription and plan, especially in relation to volume and dose; and the fourth shows how the nurse, by applying the knowledge from the previous articles, can predict, explain and care for acute side effects that may arise during a course of skin radiotherapy.

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Radiotherapy for Hidradenitis Suppurativa: A Systematic Review

Cited by 7 publications

References 22 publications

Long-Term Follow-Up after Radiotherapy of Hidradenitis Suppurativa

Long-Term Follow-Up after Radiotherapy of Hidradenitis Suppurativa

A scientific approach to skin radiotherapy nursing Article 2 - The anatomy, physiology, pathology and radiobiology of skin and its diseases

A scientific approach to skin radiotherapy nursing Article 1 - The role of the nurse in patient assessment

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