Krzysztofiak Tomasz, Kamińska-Winciorek Grażyna, Pilśniak Aleksandra, Wojcieszek Piotr
Brachytherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland.
Department of Bone Marrow Transplantation and Haematology-Oncology, Skin Cancer and Melanoma Team, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland.
Dermatol Ther. 2022 Sep;35(9):e15675. doi: 10.1111/dth.15675. Epub 2022 Jul 22.
Nonmelanoma skin cancers (NMSCs) are the most common malignancies worldwide. Millions of new cases every year present challenge to healthcare systems. Recent years brought numerous new data concerning high dose rate (HDR) brachytherapy (BT) as treatment option for NMSCs. International guidelines do not recognize BT as a method of choice given lack of randomized trials, however many prospective and retrospective studies show promising results. Aim of the study was to present the efficacy of HDR BT, with analysis of its safety and adverse effects based on review of the English published medical full-text papers. Literature review of 13 articles published between 1999 and 2021 was performed. Pubmed and Google Scholar databases were searched on October 2021 using keywords: ([Basal cell carcinoma] OR [squamous cell carcinoma] OR [non-melanoma skin cancer]) AND (HDR brachytherapy). Fourteen full-text English articles with follow up over 1 year and study group over 50 patients were included into analysis. In analyzed material, 2403 patients received HDR BT. Local control varied between 71% and 99%.Dominant reported cosmetic effect was good or very good. Results were cross-referenced with recent meta-analyses comparing BT to surgical excision, Mohs microsurgery and external beam radiotherapy. Radiodermitis is the main adverse effect of radiation treatment during and after radiotherapy. HDR BT emerges as potentially noninferior treatment method providing very good reported cosmetic outcomes.
非黑色素瘤皮肤癌（NMSCs）是全球最常见的恶性肿瘤。每年数百万的新发病例给医疗系统带来了挑战。近年来出现了大量关于高剂量率（HDR）近距离放射治疗（BT）作为NMSCs治疗选择的新数据。由于缺乏随机试验，国际指南未将BT视为首选方法，然而许多前瞻性和回顾性研究显示出了有前景的结果。本研究的目的是基于对已发表的英文医学全文论文的综述，介绍HDR BT的疗效，并分析其安全性和不良反应。对1999年至2021年间发表的13篇文章进行了文献综述。2021年10月在PubMed和谷歌学术数据库中使用关键词进行搜索：（[基底细胞癌]或[鳞状细胞癌]或[非黑色素瘤皮肤癌]）以及（HDR近距离放射治疗）。纳入分析的有14篇随访超过1年且研究组超过50例患者的英文全文文章。在分析的资料中，2403例患者接受了HDR BT。局部控制率在71%至99%之间。报告的主要美容效果为良好或非常好。将结果与最近比较BT与手术切除、莫氏显微外科手术和外照射放疗的荟萃分析进行了交叉对照。放射性皮炎是放疗期间及放疗后的主要放疗不良反应。HDR BT作为一种潜在的非劣效治疗方法出现，报告的美容效果非常好。
