Farberg Aaron S, Heysek Randy V, Haber Robert, Agha Rania, Crawford Kevin M, Xinge Ji, Stricker Jeffrey Blake
Bare Dermatology, Dallas, TX 75235, USA.
University of North Texas Health Science Center, University of North Texas, Fort Worth, TX 76107, USA.
Geriatrics (Basel). 2024 Sep 5;9(5):114. doi: 10.3390/geriatrics9050114.
Non-melanoma skin cancers (NMSCs) are a significant cause of morbidity and mortality; their incidence is increasing most in older patients. NMSCs have traditionally been treated with surgical excision, curettage, Mohs micrographic surgery (MMS), and superficial radiotherapy (SRT). Image-guided SRT (IGSRT) is a treatment option for poor surgical candidates or patients with low- or high-risk, early-stage NMSC who prefer to avoid surgery. This large retrospective cohort study compared 2-, 4-, and 6-year freedom from recurrence in biopsy-proven NMSC lesions treated with IGSRT ( = 20,069 lesions) between patients aged < 65 years ( = 3158 lesions) and ≥65 years ( = 16,911 lesions). Overall freedom from recurrence rates were 99.68% at 2 years, 99.57% at 4 years, and 99.57% at 6 years. Rates did not differ significantly by age ( = 0.8) nor by sex among the two age groups ( > 0.9). There was a significant difference in recurrence among older patients when analyzed by stage ( = 0.032), but no difference by stage in younger patients ( = 0.7). For early-stage NMSCs, IGSRT is a clinically equivalent alternative to MMS and statistically significant in superiority to non-image-guided SRT. This study demonstrates that there is no significant effect of age on 2-, 4-, or 6-year freedom from recurrence in patients with IGSRT-treated NMSC.
非黑色素瘤皮肤癌（NMSCs）是发病和死亡的重要原因；其发病率在老年患者中增长最为显著。传统上，NMSCs的治疗方法包括手术切除、刮除术、莫氏显微外科手术（MMS）和浅表放射治疗（SRT）。图像引导浅表放射治疗（IGSRT）是手术条件较差或患有低风险或高风险早期NMSC且不愿接受手术的患者的一种治疗选择。这项大型回顾性队列研究比较了接受IGSRT治疗的活检证实的NMSC病变（n = 20,069个病变）在年龄＜65岁（n = 3158个病变）和≥65岁（n = 16,911个病变）的患者中2年、4年和6年无复发率。总体无复发率在2年时为99.68%，4年时为99.57%，6年时为99.57%。无复发率在年龄组间无显著差异（P = 0.8），在两个年龄组的性别间也无显著差异（P＞0.9）。按分期分析时，老年患者的复发率有显著差异（P = 0.032），但年轻患者按分期无差异（P = 0.7）。对于早期NMSCs，IGSRT在临床上等同于MMS，且在统计学上显著优于非图像引导的SRT。本研究表明，年龄对接受IGSRT治疗的NMSC患者的2年、4年或6年无复发率无显著影响。
