Superficial x-ray in the treatment of basal and squamous cell carcinomas: A viable option in select patients

Cognetta, Armand B.; Howard, Brett; Heaton, Henry; Stoddard, Earl R.; Hong, Hyokyoung Grace; Green, W. Harris

doi:10.1016/j.jaad.2012.06.001

Cited by 132 publications

(115 citation statements)

References 25 publications

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“…Radiation therapy can be used successfully to treat NMSC and has the benefit of sparing normal, healthy tissue [57]. It is an alternative treatment for inoperable NMSC [58].…”

Section: Classical Therapy Of Nmscsmentioning

confidence: 99%

Neoplastic Multifocal Skin Lesions: Biology, Etiology, and Targeted Therapies for Nonmelanoma Skin Cancers

Fernandes

Santos²,

Kovačević³

et al. 2017

Skin Pharmacol Physiol

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Neoplastic skin lesions are multifocal, diffuse skin infiltrations of particular relevance in the differential diagnosis of ulcerative, nodular, or crusting skin lesions. Nonmelanoma skin cancers (NMSCs), namely, basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and also actinic keratosis (AK), are the most common malignant tumors in humans. BCCs do not proliferate rapidly and most of the times do not metastasize, while SCCs are more infiltrative, metastatic, and destructive. AKs are precursor lesions of cutaneous SCCs. The classical therapy of NMSCs makes use of photodynamic therapy associated with chemotherapeutics. With improved understanding of the pathological mechanisms of tumor initiation, progression, and differentiation, a case is made towards the use of targeted chemotherapy with the intent to reduce the cytotoxicity of classical treatments. The present review aims to describe the current state of the art on the knowledge of NMSC, including its risks factors, oncogenes, and skin carcinogenesis, discussing the classical therapy against new therapeutic options.

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“…Radiation therapy can be used successfully to treat NMSC and has the benefit of sparing normal, healthy tissue [57]. It is an alternative treatment for inoperable NMSC [58].…”

Section: Classical Therapy Of Nmscsmentioning

confidence: 99%

Neoplastic Multifocal Skin Lesions: Biology, Etiology, and Targeted Therapies for Nonmelanoma Skin Cancers

Fernandes

Santos²,

Kovačević³

et al. 2017

Skin Pharmacol Physiol

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“…70 A retrospective analysis of 1715 lesions treated over 10 years (including the past 2 years with the SRT-100 unit) found 5-year recurrence rates of 4.2% for basal cell carcinoma (BCC) and 5.8% for squamous cell carcinoma (SCC) tumours. 72 Initial experience of using the Xoft device for these patients has also been reported. 73 37 patients were treated using a dose of 40 Gy in 8 fractions, prescribed to a depth of 3-7 mm.…”

Section: Clinical Applications Skinmentioning

confidence: 99%

Electronic brachytherapy—current status and future directions

Eaton¹

2015

BJR

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In the past decade, electronic brachytherapy (EB) has emerged as an attractive modality for the treatment of skin lesions and intraoperative partial breast irradiation, as well as finding wider applications in intracavitary and interstitial sites. These miniature X-ray sources, which operate at low kilovoltage energies (,100 kV), have reduced shielding requirements and inherent portability, therefore can be used outside the traditional realms of the radiotherapy department. However, steep dose gradients and increased sensitivity to inhomogeneities challenge accurate dosimetry. Secondly, ease of use does not mitigate the need for close involvement by medical physics experts and consultant oncologists. Finally, further studies are needed to relate the more heterogeneous dose distributions to clinical outcomes. With these provisos, the practical convenience of EB strongly suggests that it will become an established option for selected patients, not only in radiotherapy departments but also in a range of operating theatres and clinics around the world.

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“…Recently new techniques to precisely deliver the radiation to the target tumor has been developed that prevent damage to the surrounding healthy tissues and cause minimal radiation toxicities. Currently, interstitial highdose-rate (HDR) brachytherapy and electronic surface brachytherapy (ESB) are the new techniques being used to treat various nonmelanoma skin malignancies including the eyelid carcinomas [10][11][12][13][14][15].…”

Section: Editorialmentioning

confidence: 99%

“…A novel non-invasive modality, ESB (low energy x-ray HDR, ~50 kV) is currently used to treat non-melanoma skin cancers [13][14][15]. ESB delivers high dose of radiation to the local tumor with rapid dose fall off to the surrounding healthy tissues.…”

Section: Editorialmentioning

confidence: 99%

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What is New in the Treatment of Eyelid Tumors with Radiation Therapy?

Turaka¹,

Turaka²,

Koneru³

2016

OMICS J Radiol

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EditorialMalignant tumors of the eyelids can cause considerable functional and aesthetic complications. Most common eyelid tumor is basal cell carcinoma (BCC) followed by squamous cell carcinoma, sebaceous gland carcinoma, Merkel cell carcinoma and malignant melanoma (rare) [1]. They can be located at lower eyelid (most common site) or upper eyelid, outer canthus and inner canthus. Surgical excision is the standard primary treatment option for the eyelid tumors. However, in cases with incompletely excised primary tumors, recurrent tumors, or inoperable large primary tumors and elderly patients who cannot tolerate general anesthesia with significant co-morbidities, radiation therapy (RT) is considered as an effective alternative/adjuvant treatment modality [2][3][4][5][6][7]. Different radiation therapeutic methods such as external beam radiotherapy (EBRT) with x-rays [superficial (45-100 Kv), orthovoltage (100-250 Kv)] or megavoltage photons & electrons and radionuclide plaque brachytherapy has been used to treat various eyelid tumors with good success [2][3][4][5][6][7][8][9]. However, acute and chronic radiation side-effects (skin reactions, eyelid telangiectasia, eyelid atrophy, eyelash loss (madarosis), epiphora (tearing), ocular surface disorders (dry eyes), cataract, radiation papillopathy, retinopathy & maculopathy and second malignant neoplasms) can lead to significant functional and visual disabilities. Recently new techniques to precisely deliver the radiation to the target tumor has been developed that prevent damage to the surrounding healthy tissues and cause minimal radiation toxicities. Currently, interstitial highdose-rate (HDR) brachytherapy and electronic surface brachytherapy (ESB) are the new techniques being used to treat various nonmelanoma skin malignancies including the eyelid carcinomas [10][11][12][13][14][15].Contact X-ray radiotherapy (50 kV) was used in the past to treat the small (<2 cm) eyelid tumors. At a dose of 42 Gray (Gy)/7 fractions/ 4 weeks, there was excellent regression of the tumors with long-term tumor control in 98%. However, loss of eye lashes, punctal stenosis, skin depigmentation was noticed even at doses of 1 or 2 fractions of 6 Gy per week. Also local tumor relapse was seen in few cases around the irradiated area. The cosmetic results were good with x-ray RT [2]. Following orthovoltage radiotherapy of medial canthal BCC, 10-year tumor control rate was 94% with no recurrence rates. However, patients developed significant complications within the radiation field such as madarosis, epiphora, ocular surface disorders and conjunctival scarring [3]. When eyelid tumors (1-4 cm size) were treated by electron beam therapy at a dose of 45-70 Gy in daily fractions of 2-4 Gy, though there was reasonable local tumor regression, few cases had recurrences (11%) and few had local radiation side effects such as skin atrophy and mild deformities [4].EBRT can be considered another option for treating the eyelid tumors [5][6][7]. Primary eyelid tumors when treated with median radiatio...

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Superficial x-ray in the treatment of basal and squamous cell carcinomas: A viable option in select patients

Cited by 132 publications

References 25 publications

Neoplastic Multifocal Skin Lesions: Biology, Etiology, and Targeted Therapies for Nonmelanoma Skin Cancers

Neoplastic Multifocal Skin Lesions: Biology, Etiology, and Targeted Therapies for Nonmelanoma Skin Cancers

Electronic brachytherapy—current status and future directions

What is New in the Treatment of Eyelid Tumors with Radiation Therapy?

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