辅助放疗在皮肤鳞状细胞癌切缘阴性后的疗效。

Outcomes of Adjuvant Radiotherapy Following Negative Surgical Margins for Cutaneous Squamous Cell Carcinoma.

机构信息

Departments of Dermatology.

Radiation Oncology, and.

出版信息

Dermatol Surg. 2019 Sep;45(9):1111-1116. doi: 10.1097/DSS.0000000000001827.

DOI:10.1097/DSS.0000000000001827

PMID:30893176

Abstract

BACKGROUND

The role of adjuvant radiotherapy (ART) for cutaneous squamous cell carcinoma (cSCC) following negative surgical margins is unclear.

OBJECTIVE

To retrospectively examine the clinical outcomes in a cohort of patients with cSCC who completed ART after Mohs micrographic surgery or wide local excision with negative margins.

METHODS AND MATERIALS

After the institutional review board approval, a retrospective review was conducted of all patients with cSCC treated in the Mayo Clinic Department of Radiation Oncology from March 10, 1998, through April 26, 2013. Inclusion criteria were age >18 years, resection with negative histologic surgical margins, and completion of ART.

RESULTS

Thirty-two patients met the inclusion criteria: 15 patients died, 12 without evidence of disease related to cSCC. Three patients developed recurrent disease, all with poorly differentiated cSCC, > 2 cm in clinical diameter, perineural invasion, and Brigham and Women's (BWH) stage T2b/T3; 2 of 3 patients were immunosuppressed; and 2 of 3 patients died of cSCC-related causes.

CONCLUSION

These data suggest that the combination of surgical resection and ART is a reasonable option for Brigham and Women's T2b/T3 tumors.

摘要

背景

对于切缘阴性的皮肤鳞状细胞癌（cSCC），辅助放疗（ART）的作用尚不清楚。

目的

回顾性分析接受 Mohs 显微外科或广泛局部切除且切缘阴性的 cSCC 患者完成 ART 后的临床结果。

方法和材料

在机构审查委员会批准后，对 1998 年 3 月 10 日至 2013 年 4 月 26 日期间在梅奥诊所放射肿瘤学系接受治疗的所有 cSCC 患者进行了回顾性分析。纳入标准为年龄>18 岁，切除术后组织学切缘阴性，且完成 ART。

结果

32 例患者符合纳入标准：15 例患者死亡，其中 12 例与 cSCC 无关。3 例患者发生复发性疾病，均为分化差的 cSCC，临床直径>2cm，存在神经周围侵犯，且 Brigham and Women's（BWH）分期为 T2b/T3；3 例患者中有 2 例为免疫抑制；3 例患者中有 2 例死于 cSCC 相关原因。