Advanced non-melanoma skin cancer in elderly patients: When surgery says NO, interventional radiotherapy (brachytherapy) says YES.
HDR
PDR
advanced skin cancer
brachytherapy
elderly patients
Journal
Journal of contemporary brachytherapy
ISSN: 1689-832X
Titre abrégé: J Contemp Brachytherapy
Pays: Poland
ID NLM: 101506276
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
26
06
2023
accepted:
29
07
2023
medline:
6
10
2023
pubmed:
6
10
2023
entrez:
6
10
2023
Statut:
ppublish
Résumé
The prevalence of non-melanoma skin cancer (NMSC) increases, especially in older adults with comorbidities, narrowing radical treatment options. About 5% of skin cancer patients are diagnosed with an advanced stage, which impairs daily functioning. The study was to present a retrospective summary of elderly patients unfit for surgery and treated with various brachytherapy (BT) techniques tailored individually for locally advanced NMSCs in a reference BT department. Clinical case presentations supported the findings. Inoperable patients older than 75 years presenting with advanced pathologically confirmed NMSCs were retrospectively identified. All cases were individually assessed, and the best suiting radical treatment option was chosen, including contact, interstitial, or hybrid high-dose-rate (HDR) or pulsed-dose-rate (PDR) BT. Doses ranging from 45 to 60 Gy were administered to clinical target volume (CTV) in different time schedules. All patients were closely followed-up until complete remission. Ten elderly patients (mean age, 84 years) with differently located locally advanced NMSCs (all staged T3) were treated between 2007 and 2022. Six basal and four squamous cell carcinoma cases showed most painful symptoms as well as bleeding and exudation. Six patients underwent HDR-BT and four PDR-BT. Six patients had superficial, and four interstitial or hybrid applications. All patients completed the intended protocols. Median follow-up was 8.5 months (range, 3-35 months). Six out of ten patients died from other reasons before analysis. All case data were presented in the text and respective figures. Advanced NMSCs in elderly patients are challenging in terms of cure. Inoperable cases may be referred for feasible and locally effective interventional radiotherapy (BT). Individually tailored BT leads to an excellent disease control, function sparing, symptoms release, and quality of life improvement. Large treated volumes are related to prolonged healing. BT should be discussed in a multidisciplinary tumor board regarding older patients with symptomatic functions affecting advanced NMSCs.
Identifiants
pubmed: 37799126
doi: 10.5114/jcb.2023.130715
pii: 51298
pmc: PMC10548428
doi:
Types de publication
Journal Article
Langues
eng
Pagination
235-244Informations de copyright
Copyright © 2023 Termedia.
Déclaration de conflit d'intérêts
The authors report no conflict of interest.
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