Applying New Technologies for Skin Cancers

There are a number of radiation treatments for nonmelanoma skin cancer, including superficial radiation therapy (SRT), electronic beam therapy (EBT), and isotopic brachytherapy, noted Brian Berman, from the Center for Clinical and Cosmetic Research and voluntary professor at the University of Miami School of Medicine during his discussion “Superficial Radiation Therapy (SRT) for NMSC.” He began with a conversation about the recently FDA-cleared SRT-100 system for the treatment of nonmelanoma skin cancer (NMSC), for all body surfaces.

Why would dermatology HCPs want to add this to their arsenal? As Berman explains, the SRT-100 generates low energy photon X-rays at variable peak voltages(50, 70, and 100 kVp), “avoiding damage to the deeper, normal tissue,” he explains. The device offers a planned, calibrated, accurate, and controlled dose, which is deposited in a uniform distribution, with various applications allowing treatment for areas up to 180 mm. In a multicenter study of the SRT for NMSC, it was estimated that the 98% of these cancers did not recur after 85 months.

Next, Berman walked the attendees through using an image-guided superficial radiotherapy (IGSRT) for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). This technology uses low levels of X-rays that combine with radiotherapy protocols for NMSC. Studies have shown that IGSRT is a first-line treatment choice for early-stage BCC and SCC; Berman highlighted a 2021 study that showed, of the 2917 keratinocyte carcinomas that underwent IGSRT, 2897 lesions were nearly 100% clear at 1 year. The American Academy of Dermatology recommends, “if surgical therapy is not feasible or preferred, radiation therapy (ie, superficial radiation therapy…) can be considered when tumors are low risk, with the understanding that the cure rate may be lower.”

Electronic brachytherapy (eBX) uses a nonisoptopic, 50kV, X-ray source near the tumor, targeting the tumor site with an applicator 10mm to 50mm in diameter. A study using this surface eBX in 1259 patients successfully treated showed a 1% recurrence rate.

In summary, Berman noted, “Changing demographics, the increase of NMSC and new innovations are bringing SRT back into dermatology. There is significant evidence on the benefits of SRT with high cure rates and low acute and latent side effects,” something to think when treating a patient with these conditions.

Reference

Berman B. Superficial Radiation therapy (SRT) for NMSC. Fall Clinical Dermatology Conference 2022. October 20, 2022. Las Vegas, Nevada.