Ma Liqiao, Digby Michael, Wright Kevin, Germain Marguerite A, McClure Erin M, Kartono Francisca, Rahman Syed, Friedman Scott D, Osborne Candace, Desai Alpesh
Tru-Skin Dermatology, Austin, TX 78731, USA.
Renew Family Dermatology, Fort Payne, AL 35968, USA.
Cancers (Basel). 2024 Dec 1;16(23):4037. doi: 10.3390/cancers16234037.
Non-melanoma skin cancers (NMSCs) are the most common cancers in the United States. Image-guided superficial radiation therapy (IGSRT) is an effective treatment for NMSCs. Patient comorbidities and socioeconomic status (SES) are known contributors to health disparities. However, the impact of comorbidities or SES on the outcomes of IGSRT-treated NMSCs has not yet been studied. This study evaluated freedom from recurrence in IGSRT-treated NMSCs stratified by SES and the number of comorbidities.
This large retrospective cohort study evaluated associations between SES (via Area Deprivation Index (ADI)) or comorbidity (via Charlson Comorbidity Index (CCI)) and 2-, 4-, and 6-year year freedom from recurrence in patients with IGSRT-treated NMSC ( = 19,988 lesions).
Freedom from recurrence in less (ADI ≤ 50) vs. more (ADI > 50) deprived neighborhoods was 99.47% vs. 99.61% at 6 years, respectively ( = 0.2). Freedom from recurrence in patients with a CCI of 0 (low comorbidity burden) vs. a CCI of ≥7 (high comorbidity burden) was 99.67% vs. 99.27% at 6 years, respectively ( = 0.9).
This study demonstrates that there are no significant effects of SES or comorbidity burden on freedom from recurrence in patients with IGSRT-treated NMSC. This supports the expansion of IGSRT in deprived neighborhoods to increase access to care, and IGSRT should be a consideration even in patients with a complex comorbidity status.
非黑色素瘤皮肤癌（NMSCs）是美国最常见的癌症。图像引导浅表放射治疗（IGSRT）是治疗NMSCs的一种有效方法。患者的合并症和社会经济地位（SES）是导致健康差异的已知因素。然而，合并症或SES对IGSRT治疗的NMSCs疗效的影响尚未得到研究。本研究评估了按SES和合并症数量分层的IGSRT治疗的NMSCs的无复发生存率。
这项大型回顾性队列研究评估了SES（通过地区贫困指数（ADI））或合并症（通过Charlson合并症指数（CCI））与IGSRT治疗的NMSC患者（n = 19,988个病灶）2年、4年和6年无复发生存率之间的关联。
在6年时，贫困程度较低（ADI≤50）与较高（ADI>50）社区的无复发生存率分别为99.47%和99.61%（P = 0.2）。CCI为0（低合并症负担）与CCI≥7（高合并症负担）的患者在6年时的无复发生存率分别为99.67%和99.27%（P = 0.9）。
本研究表明，SES或合并症负担对IGSRT治疗的NMSC患者的无复发生存率没有显著影响。这支持在贫困社区扩大IGSRT以增加医疗服务可及性，并且即使是合并症情况复杂的患者也应考虑使用IGSRT。
