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Zaorsky NG, Lee CT, Zhang E, Galloway TJ
Skin CanceR Brachytherapy vs External beam radiation therapy (SCRiBE) meta-analysis
Radiother Oncol (2018) 126:386-393.
BACKGROUND AND PURPOSE: To compare cosmesis and local recurrence (LR) of definitive external beam radiation therapy (EBRT) vs brachytherapy (BT) for indolent basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the skin. MATERIALS AND METHODS: Studies including patients with T1-2N0 SCCs/BCCs treated with definitive EBRT/BT and >/=10months follow-up were analyzed. The primary endpoint was post-treatment cosmesis, categorized as "good," "fair," or "poor." The secondary endpoint was LR. Mixed effects regression models were used to estimate weighted linear relationships between biologically equivalent doses with alpha/beta=3 (BED3) and cosmetic outcomes. RESULTS: A total of 9965 patients received EBRT and 553 received BT across 24 studies. Mean age was 73years, median follow-up was 36months, and median dose was 45Gy/10 fractions at 4.4Gy/fraction. At BED3 of 100Gy, "good" cosmesis was more frequently observed in patients receiving BT, 95% (95% CI: 88-100%) vs 79% (95% CI: 60-82%), p<0.05. Similar results were found for "good" cosmesis at BED3 >100Gy. No difference in "poor" cosmesis was noted at any BED3. LR was<7% for both at one year. CONCLUSION: BT has favorable cosmesis over EBRT for skin SCCs/BCCs at common fractionation regimens. Prospective studies comparing EBRT vs BT are warranted.
Publication Date: 2018-03-01.
Last updated on Friday, July 03, 2020