Epithelian skin cancerEfficacy of a hypofractionated schedule in electron beam radiotherapy for epithelial skin cancer: Analysis of 434 cases
Section snippets
Patients
A total of 434 biopsy-proven epithelial skin tumours in 333 patients treated in our centre from January 2001 to December 2006 were retrospectively analysed. A total of 332 (76.5%) basal cell carcinomas and 102 (23.5%) squamous cell carcinomas were treated. Patients were referred for primary treatment after a biopsy (n = 386) or after surgical treatment in case of residual disease (n = 48). The median age of patients with BCC was 74.8 years (range 38.4–95.5 years), median age of patients with SCC was
Results
Median follow-up for patients alive was 42.8 months (range 1.4–87.6); 64.4 months (range 19.2–87.6) in the 54 Gy group and 31.9 months (1.4–71.9) in the 44 Gy group.
Discussion
In this large retrospective study two fractionation schedules (44 Gy in 10 fractions and 54 Gy in 18 fractions) for electron beam irradiation of epithelial skin cancer were evaluated. Both fractionation schedules were found to be effective. Actuarial 3-year local recurrence free rates were 97.5% and 96.1% for 54 and 44 Gy, respectively. Local control was similar for BCC and SCC. In the 44 Gy group LRF rate for SCC was slightly lower with 93.6% versus 96.9% for BCC, this difference was not
Conclusions
Electron beam irradiation is an excellent treatment modality for epithelial skin cancer, especially in cosmetically sensitive areas for which surgery is less favourable and for postoperative treatment in case of residual or recurrent disease. In view of a similar efficacy and the patient convenience of the hypofractionated schedule, 44 Gy in 10 fractions can be regarded optimal therapy for T1–T2 BCC and SCC.
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2018, Radiation Physics and ChemistryCitation Excerpt :Such a reduction in dose could compromise treatment outcome especially for single-fraction electron treatments or treatment regimes using a small number of fractions. For instance: the single-fraction electron treatment of CD30+ lymphoproliferative disorder (LPD) lesions using a dose of 750–800 cGy (Gentile et al., 2015); intraoperative radiotherapy (IORT) of a breast quadrant after lumpectomy using a single dose of 21 Gy which is equivalent to 60 Gy delivered in 30 fractions at 2 Gy/fraction (Veronesi et al., 2001; Petoukhova et al., 2017); the kilovoltage or electron therapy of epithelial skin lesions (basal cell carcinomas, BCCs or squamous cell carcinomas, SCCs) and scleredema of Buschke using 3–10 fractions (Van Hezewijk et al., 2010; McPartlin et al., 2014; Skrepnik et al., 2016) or a boosting to the original tumour site requiring 10–16 Gy in 5–8 fractions following whole-breast tissue irradiation for breast cancer patients who underwent breast-conserving surgery (Small et al., 2013; Park and Kim, 2013). Hence, for a treatment regime using four or five irradiation fractions, the QED and EDP diodes would reduce the prescribed dose by approximately 2% and 3%, respectively if only single IVD measurements are performed at the beginning of the treatment session using the diodes.