INTRODUCTION
Nonmelanoma skin cancer (NMSC) comprises basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and numerous less common skin tumors.1 NMSCs are the commonest form of malignancy among Caucasians2 and its incidence continues to rise worldwide.3 Although Mohs surgery has traditionally been regarded as the gold-standard for treating NMSC,4 it may not be suitable for the elderly due to frailty, limited life-expectancy, and comorbidities.5-7
Superficial radiation therapy (SRT) comprises low energy X-rays produced by units generally operating in the 50 to 150 kV range. SRT was the standard of care for office-based radiation treatment of NMSCs for more than 100 years but declined during the 1980s due to an increase in the popularity of Mohs micrographic surgery and because there were no new devices to replace older ones;8 however, the use of SRT is currently seeing a resurgence following the reintroduction of newer, easy-to-use SRT equipment.9 Low-dose SRT effectively treats NMSC without requiring invasive excision.10 SRT can be performed as an office procedure without anesthesia,11 minimal risk of infection and superior cosmetic outcomes.12 Recovery is rapid with no or minimal downtime or lifestyle restrictions. SRT has been shown to be safe and very effective among elderly who comprise the majority of patients with NMSC.8,13
The objective of this retrospective chart review was to further demonstrate the long-term efficacy of SRT for treating NMSCs with a new generation device.
Superficial radiation therapy (SRT) comprises low energy X-rays produced by units generally operating in the 50 to 150 kV range. SRT was the standard of care for office-based radiation treatment of NMSCs for more than 100 years but declined during the 1980s due to an increase in the popularity of Mohs micrographic surgery and because there were no new devices to replace older ones;8 however, the use of SRT is currently seeing a resurgence following the reintroduction of newer, easy-to-use SRT equipment.9 Low-dose SRT effectively treats NMSC without requiring invasive excision.10 SRT can be performed as an office procedure without anesthesia,11 minimal risk of infection and superior cosmetic outcomes.12 Recovery is rapid with no or minimal downtime or lifestyle restrictions. SRT has been shown to be safe and very effective among elderly who comprise the majority of patients with NMSC.8,13
The objective of this retrospective chart review was to further demonstrate the long-term efficacy of SRT for treating NMSCs with a new generation device.
METHODS
Seven clinical centers across the US that treated NMSCs with SRT for at least 5 years were contacted to participate. Sites were required to have treated at least 50 patients with ≥5-year follow-up. Three sites declined or did not respond. The study was therefore conducted in four clinical practices, where three of the four investigators were also Mohs surgeons. Retrospective chart reviews identified 516 subjects treated for 776 histologically confirmed, primary, cutaneous NMSC lesions. Relevant clinical
