Freedom from Recurrence across Age in Non-Melanoma Skin Cancer Treated with Image-Guided Superficial Radiation Therapy

Author:

Farberg Aaron S.12,Heysek Randy V.3,Haber Robert4ORCID,Agha Rania567ORCID,Crawford Kevin M.89,Xinge Ji10,Stricker Jeffrey Blake111213

Affiliation:

1. Bare Dermatology, Dallas, TX 75235, USA

2. University of North Texas Health Science Center, University of North Texas, Fort Worth, TX 76107, USA

3. Central Florida Cancer Institute, Davenport, FL 33837, USA

4. Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA

5. Department of Dermatology, The University of Illinois at Chicago, Chicago, IL 60607, USA

6. Jesse Brown VA Medical Center, Chicago, IL 60612, USA

7. Department of Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USA

8. Department of Dermatology, Marian University College of Osteopathic Medicine, Indianapolis, IN 46222, USA

9. Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN 46202, USA

10. Independent Researcher, Champaign, IL 61822, USA

11. Dermatology Specialists of Alabama, Dothan, AL 36303, USA

12. Alabama College of Osteopathic Medicine, Dothan, AL 36303, USA

13. Southeast Health Internal Medicine Residency, Dothan, AL 36301, USA

Abstract

Non-melanoma skin cancers (NMSCs) are a significant cause of morbidity and mortality; their incidence is increasing most in older patients. NMSCs have traditionally been treated with surgical excision, curettage, Mohs micrographic surgery (MMS), and superficial radiotherapy (SRT). Image-guided SRT (IGSRT) is a treatment option for poor surgical candidates or patients with low- or high-risk, early-stage NMSC who prefer to avoid surgery. This large retrospective cohort study compared 2-, 4-, and 6-year freedom from recurrence in biopsy-proven NMSC lesions treated with IGSRT (n = 20,069 lesions) between patients aged < 65 years (n = 3158 lesions) and ≥65 years (n = 16,911 lesions). Overall freedom from recurrence rates were 99.68% at 2 years, 99.57% at 4 years, and 99.57% at 6 years. Rates did not differ significantly by age (p = 0.8) nor by sex among the two age groups (p > 0.9). There was a significant difference in recurrence among older patients when analyzed by stage (p = 0.032), but no difference by stage in younger patients (p = 0.7). For early-stage NMSCs, IGSRT is a clinically equivalent alternative to MMS and statistically significant in superiority to non-image-guided SRT. This study demonstrates that there is no significant effect of age on 2-, 4-, or 6-year freedom from recurrence in patients with IGSRT-treated NMSC.

Funder

Dermatology Association of Radiation Therapy

Publisher

MDPI AG

Reference41 articles.

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