Image-guided superficial radiation therapy (IGSRT) is a safe and effective first-line treatment for nonmelanoma skin cancer (NMSC), according to expert consensus recommendations published in SKIN: The Journal of Cutaneous Medicine.
IGSRT utilizes high-resolution dermal ultrasound (HRDUS) in conjunction with SRT to visualize tumors before, during, or after treatment.
For the report, six dermatologists with expertise in managing NMSC reviewed 12 published studies on IGSRT. The panel unanimously voted to adopt eight statements, with an additional two statements receiving five out of six votes for adoption.
The panel unanimously agreed that:
- SRT is a well-established modality for treating NMSC, dependent on individual patient characteristics. ISGSRT adds US visualization that can help evaluate the depth and breadth of the tumor.
- IGSRT is a safe and effective treatment option for NMSC.
- Dermatologists are the most appropriate clinicians to direct and administer SRT, including IGSRT.
- SRT, including IGSRT, can be considered a first-line treatment for NMSC for appropriately selected patients
- SRT, including IGSRT, may be the optimal treatment for certain patients depending on individual patient factors, such as age, comorbidity, patient preferences, tumor location, tumor histology, and other factors
- SRT, including IGSRT, may not be medically optimal in certain clinical situations
- Patients with NMSC need to be offered all appropriate treatment options and should be a part of the decision-making process
- Based on available data, SRT, including IGSRT, provides superior outcomes overall to electron beam.
The experts point out that studies have not investigated SRT, including IGSRT’s efficacy for high-risk stage 3 or stage 4 tumors, and there is no data available on its use for recurrent NMSCs.
The panelists similarly stress that the mean follow-up duration of approximately 70 weeks may not be long enough to capture all recurrences.
“Given the importance of shared decision making, they emphasized the need to discuss the risks and benefits of all available options when creating a treatment plan, incorporating patient preferences, patient history, and tumor characteristics into the final management decision,” the study authors conclude.
