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Superficial x-ray in the treatment of basal and squamous cell carcinomas: A viable option in select patients - 14/11/12

Doi : 10.1016/j.jaad.2012.06.001 
Armand B. Cognetta, MD a, Brett M. Howard, BA b, Henry P. Heaton, BA c, Earl R. Stoddard, MD d, Hyokyoung Grace Hong, PhD e, W. Harris Green, MD a,
a Dermatology Associates of Tallahassee, Tallahassee, Florida 
b Florida State University College of Medicine, Tallahassee, Florida 
c State University of New York Downstate Medical Center, Brooklyn, New York 
d Idaho Skin Institute, Pocatello, Idaho 
e Department of Statistics and Computer Information Systems, Baruch College, City University of New York, New York, New York 

Reprint requests: W. Harris Green, MD, Dermatology Associates of Tallahassee, 1707 Riggins Rd, Tallahassee, FL 32308.

Abstract

Background

Effective nonsurgical modalities are limited in the treatment of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).

Objective

We sought to evaluate the efficacy and viability of superficial x-ray therapy in the treatment of BCC and SCC in an outpatient setting.

Methods

A retrospective analysis was performed on 1715 histologically confirmed primary cutaneous BCC and SCC treated with superficial x-ray therapy at Dermatology Associates of Tallahassee in Florida between 2000 and 2010.

Results

Of the 1715 tumors reviewed during this period, 712 were histologically proven BCC (631 nodular and 81 superficial), 994 were SCC (861 SCC in situ and 133 invasive SCC), and 9 displayed distinct features of both BCC and SCC in the same biopsy specimen. Kaplan-Meier estimates (with 95% confidence intervals) of cumulative recurrence rates of all tumors at 2 and 5 years were 1.9% (1%-2.7%) and 5.0% (3.2%-6.7%), respectively; of BCC at 2 and 5 years were 2% (0.8%-3.3%) and 4.2% (1.9%-6.4%), respectively; and of all SCC at 2 and 5 years were 1.8% (0.8%-2.8%) and 5.8% (2.9%-8.7%), respectively. Tumors on male patients and those with a diameter greater than 2 cm were associated with a statistically significant increase in recurrence likelihood.

Limitations

This study represents only patients treated in 1 dermatology office in North Florida and may not be representative of the general patient population.

Conclusions

Superficial x-ray therapy remains a viable nonsurgical option for the treatment of primary BCC and SCC in patients where surgical intervention is declined, unadvisable, or potentially associated with significant cosmetic or functional limitations.

Le texte complet de cet article est disponible en PDF.

Key words : basal cell carcinoma, photon therapy, radiation, radiation therapy, skin cancer, squamous cell carcinoma, superficial radiation therapy, superficial x-ray therapy, x-ray, x-ray therapy

Abbreviations used : BCC, EBRT, MMS, SCC, SXRT


Plan


 Funding sources: None.
 Disclosure: Dr Cognetta has served as a medical advisor for Topex (Now Sensus Healthcare), has served as an advisor for Sensus Health Care, was given a stock option by Sensus Healthcare for his advisory role during the company’s early stages, and was an initial investor in the company. Mr Howard, Mr Heaton, and Drs Stoddard, Hong, and Green have no conflicts of interest to declare.


© 2012  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 67 - N° 6

P. 1235-1241 - décembre 2012 Retour au numéro
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  • Christian P. Rüegg, Nicole Graf, Beda Mühleisen, Thomas D. Szucs, Lars E. French, Christian Surber, Günther F.L. Hofbauer

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