Dermatology Unit "Daniele Innocenzi" Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Terracina, Italy.
Radiotherapy Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.
J Am Acad Dermatol. 2016 Feb;74(2):341-7. doi: 10.1016/j.jaad.2015.09.031. Epub 2015 Nov 14.
Radiotherapy is an established treatment for some types of patients with nonmelanoma skin cancer. A hypofractionated schedule has been proposed as a valuable option for elderly disabled patients to minimize the number of hospital visits.
We sought to compare a weekly hypofractionated orthovoltage radiotherapy regimen with a standard daily one for the treatment of nonmelanoma skin cancer.
A retrospective cohort study was performed on 436 tumors. Overall survival, disease-free survival, and cosmetic outcome were measured. Life-table analysis, Kaplan-Meier survival analysis, and multivariate Cox regression model were performed.
The hypofractionated regimen was not associated with increased recurrence rates and mortality, or with a poorer cosmetic outcome, when compared with the daily schedule.
Absence of complete information about acute treatment toxicity and a shorter follow-up time for patients receiving the weekly schedule are limitations of this study.
A weekly hypofractionated regimen of orthovoltage radiotherapy seems to be the most appropriate approach in elderly disabled patients with nonmelanoma skin cancers.
放射疗法是治疗某些类型非黑色素瘤皮肤癌患者的一种既定方法。对于老年残疾患者来说，采用低分割方案可减少住院次数，这是一种很有价值的选择。
我们旨在比较每周一次的低分割常规放疗方案与标准的每日放疗方案治疗非黑色素瘤皮肤癌的效果。
对 436 个肿瘤进行回顾性队列研究。测量总生存率、无病生存率和美容效果。进行生命表分析、Kaplan-Meier 生存分析和多变量 Cox 回归模型。
与每日方案相比，低分割方案并未导致复发率和死亡率增加，也未导致美容效果变差。
本研究的局限性在于缺乏关于急性治疗毒性的完整信息，以及每周方案患者的随访时间较短。
每周一次的低分割常规放疗方案似乎是老年残疾非黑色素瘤皮肤癌患者的最佳选择。
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