TY - JOUR
T1 - Skin CanceR Brachytherapy vs External beam radiation therapy (SCRiBE) meta-analysis
AU - Zaorsky, Nicholas G.
AU - Lee, Charles T.
AU - Zhang, Eddie
AU - Galloway, Thomas J.
N1 - Publisher Copyright:
© 2018 Elsevier B.V.
PY - 2018/3
Y1 - 2018/3
N2 - 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 T1-2 N0 SCCs/BCCs treated with definitive EBRT/BT and ≥10 months 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 α/β = 3 (BED3) and cosmetic outcomes. Results: A total of 9965 patients received EBRT and 553 received BT across 24 studies. Mean age was 73 years, median follow-up was 36 months, and median dose was 45 Gy/10 fractions at 4.4 Gy/fraction. At BED3 of 100 Gy, “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 >100 Gy. 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.
AB - 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 T1-2 N0 SCCs/BCCs treated with definitive EBRT/BT and ≥10 months 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 α/β = 3 (BED3) and cosmetic outcomes. Results: A total of 9965 patients received EBRT and 553 received BT across 24 studies. Mean age was 73 years, median follow-up was 36 months, and median dose was 45 Gy/10 fractions at 4.4 Gy/fraction. At BED3 of 100 Gy, “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 >100 Gy. 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.
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U2 - 10.1016/j.radonc.2017.12.029
DO - 10.1016/j.radonc.2017.12.029
M3 - Article
C2 - 29370985
AN - SCOPUS:85040561849
SN - 0167-8140
VL - 126
SP - 386
EP - 393
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 3
ER -