Image-guided superficial radiation therapy has superior 2-year recurrence probability to Mohs micrographic surgery

• Published in: Clinical and translational radiation oncology Vol. 43; p. 100678
• Main Authors: McClure, Erin M., Sedor, Geoffrey, Jin, Yuxuan, Kattan, Michael W.
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.11.2023; Elsevier
• Subjects: Original
• ISSN: 2405-6308; 2405-6308
• DOI: 10.1016/j.ctro.2023.100678

•2-year recurrence rate of IGSRT-treated NMSCs is statistically superior to Mohs.•Statistical superiority supports, at minimum, clinical equivalence.•This should be considered as a first-line therapy option for NMSCs.•Well suited for patients who want non-operative therapy or Mohs is contraindicated. Non-melanoma skin cancers (NMSCs) are the most common cancers in the USA, and their incidence is rising. Mohs micrographic surgery (MMS) is commonly performed to excise NMSCs. MMS replaced superficial radiotherapy (SRT) as a first line treatment, given its superior efficacy. Image-guided superficial radiation therapy (IGSRT) was invented to improve the precision of SRT. This study investigates how the 2-year recurrence probability of IGSRT-treated NMSCs compares to that of MMS-treated lesions. This retrospective cohort study compared the 2-year recurrence probability of early stage NMSCs (squamous and basal cell carcinomas (SCCs and BCCs)) treated by IGSRT (2,286 lesions) to data on NMSCs treated by MMS (5,391 lesions) via one sample proportion tests. Medical Subject Headings were used to search PubMed for reports of 2-year recurrence probability rates of NMSCs treated by MMS. Seventeen studies were screened; 14 studies were excluded for lack of 2-year time to event analysis, or irrelevant patient population (non-BCC/SCC study, advanced disease), leaving 3 studies for comparison. IGSRT-treated NMSCs have a statistically significantly improved 2-year recurrence probability than those treated by MMS, P < 0.001 for pooled data. The 2-year recurrence probability IGSRT-treated NMSCs is superior to MMS-treated and supports IGSRT as an effective treatment option for individuals with early stage NMSCs.