Radiotherapy for non-melanoma skin cancer: three different radiation techniques comparison
PO-1222
Abstract
Radiotherapy for non-melanoma skin cancer: three different radiation techniques comparison
Authors: Arquez Pianetta|, Miguel(1)*[miguelarquez@outlook.com];Torres Royo|, Laura(1);Arguís Pinel|, Mónica(1);Gómez Gómez|, David(1);López Sánchez|, Yolanda(1);Castaño Zuleta|, Fredy(1);Acosta Arteaga|, Johana(1);Gómez Ramos|, Junior(1);Murcia Mejía|, Mauricio(1);Azón|, Antoni(1);Cabré Rubio|, Núria(1);Arenas Prat|, Meritxell(1);
(1)Hospital Universitari Sant Joan de Reus, Radiotherapy, Reus, Spain;
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Purpose or Objective
Introduction
Non-melanoma skin cancer (NMSC), which is the commonest cancer, is mainly represented by basal cell carcinoma (BCC) (75%) and squamous cell carcinoma (SCC) (25%). They can be treated with surgery, radiotherapy or both, with cure rates up to 96-99% with good cosmetic result.
Purpose
NMSC treated with radiotherapy offer an excellent local control with good cosmetic results, regardless of the radiotherapy technique used.
Objective
To analyse and compare the results, toxicity and cosmesis in patients treated with electrons beam (EB), high dose rate brachytherapy (HDR) and orthovoltage (OV) for NMSC.
Material and Methods
Between 2008 and 2014, 364 NMSC were treated in our department. 117 with OV, HDR (138) or EB (109), were evaluated. Clinical response, recurrence, acute and chronic toxicity and cosmesis were analysed.
Results
With a median follow-up of 66.5 months (0-148 months), mean age was 78.36 years (36-103 years). The mean dose delivered was 49.58Gy (27Gy-70Gy) for all techniques, with mean fractionation of 3.25Gy (1.8Gy-4.5Gy). The mean dose for BCC was 47.11Gy and for SCC was 53.05Gy. 29 (5.22%) recurrences were observed: 17.2% in OV, 37.9% in EB and 44.8% in HDR (p 0.197). 62.1% of them were SCC. Four patients died due to the NMSC (2.7%), all of them were SCC histology.
Complete response was mostly appreciated in all groups. Only 0.5% BCC and 4.2% SCC had partial response, and in 2.4% BCC and 2.1% SCC the disease persisted.
Acute toxicity was greater in the OV (57.3% G3) than in EB (47.7% G2) and HDR (42.8% G2) (p 0.0001). Despite most patients did not present chronic toxicity, 7.3% G4 was detected in EB (p=0.0001). There were excellent cosmetic results reported in the patients clinical histories.
Conclusion
- We don’t observe outcome differences between radiotherapy techniques in our retrospective review.
- OV technique presents major acute toxicity with statistical significance compared with HDR and EB, however, EB present major chronic toxicity and poor cosmetics results.