Radiation Oncology Unit, Gemelli Molise Hospital, Università Cattolica del Sacro Cuore, Campobasso, Italy.
Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
Br J Radiol. 2022 Jun 1;95(1134):20211347. doi: 10.1259/bjr.20211347. Epub 2022 Apr 28.
To assess feasibility and safety of a SHort-course Accelerated RadiatiON therapy (SHARON) regimen, in the treatment of non-melanoma skin cancers (NMSC) in older patients.
Old patients (age ≥ 80 years) with histological confirmed non-melanoma skin cancers were enrolled. The primary endpoint was to determine the maximum tolerated dose (MTD). Radiotherapy regimen was based on the delivery of four radiotherapy fractions (5 Gy per fraction) with a twice daily fractionation in two consecutive days. Three different level of dose were administered: 20 Gy (one cycle), 40 Gy (two cycles) and 60 Gy (three cycles).
Thirty patients (median age: 91 years; range: 80-96) were included in this analysis. Among fourteen patients who completed the one cycle, only one (7%) experimented acute G4 skin toxicity. Twelve patients reported an improvement or resolution of baseline symptoms (overall palliative response rate: 85.8%). Nine and seven patients underwent to two and three RT cycles, respectively: of these, no G3 toxicities were recorded. The overall response rate was 100% when three cycles were delivered. The overall six-month symptom-free survival was 78.7% and 77.8% in patients treated with one course and more courses, respectively.
Short-course accelerated radiotherapy in older patients with non-melanoma skin cancers is well tolerated. High doses seem to be more effective in terms of response rate.
This approach could represent an option for older adults with NMSC, being both palliative (one course) or potentially curative (more courses) in the aim, accordingly to the patient's condition.
评估 SHort-course Accelerated RadiatiON therapy（SHARON）方案治疗老年非黑色素瘤皮肤癌（NMSC）的可行性和安全性。
纳入经组织学证实患有非黑色素瘤皮肤癌的老年患者（年龄≥80 岁）。主要终点是确定最大耐受剂量（MTD）。放射治疗方案基于在连续两天内每天两次分割给予四剂放疗（每次 5 Gy）。给予三种不同剂量水平：20 Gy（一个周期）、40 Gy（两个周期）和 60 Gy（三个周期）。
本分析纳入了 30 名患者（中位年龄：91 岁；范围：80-96 岁）。在完成一个周期的 14 名患者中，仅有 1 名（7%）出现急性 G4 皮肤毒性。12 名患者报告基线症状改善或缓解（总体姑息缓解率：85.8%）。9 名和 7 名患者分别接受了两个和三个 RT 周期，其中未记录到 G3 毒性。当给予三个周期时，总缓解率为 100%。给予一个疗程和更多疗程的患者，其六个月无症状生存率分别为 78.7%和 77.8%。
对于患有非黑色素瘤皮肤癌的老年患者，短程加速放疗耐受性良好。高剂量在反应率方面似乎更有效。
对于 NMSC 患者，这种方法可以作为一种选择，根据患者的情况，它可以是姑息性的（一个疗程）或潜在的治愈性的（更多疗程）。
