North Texas GME Research Forum 2023



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North Texas


Medical City Fort Worth



Document Type


Publication Date



dermatology, basal cell carcinoma, neoplasms


Dermatology | Neoplasms | Skin and Connective Tissue Diseases


Background: Basal cell carcinoma and squamous cell carcinoma are the most common types of non-melanoma skin cancers.1 Superficial radiation therapy (SRT) is a treatment modality that utilizes low-energy x-rays to disrupt cell mitosis.2 While this technique has been used for over a century, it has recently gained favor in clinical practice.3,4 This method of treatment offers favorable outcomes and advantages for select patients. Although the incidence of cancer recurrence after superficial radiation therapy is low, relatively little is known regarding predictive patterns. The frequency and timing of cancer recurrence is not well defined using SRT delivered technology with an image-guided approach utilizing high-frequency ultrasound capabilities.3,5 Methods: A retrospective chart review study was performed on patients treated with image-guided SRT at an academic dermatology clinic between December 2018 to December 2021. Follow-up was through December 2022. Demographic information and medical history related to the population were analyzed as part of the data set. Treatment failure and cancer recurrence were monitored to compare possible differences in treatment response. The primary endpoint was any histologically confirmed non-melanoma skin cancer identified within the treatment field at any follow-up visit. Results: There were 341 non-melanoma skin cancers treated with SRT in 165 individuals during the reviewed dates. Out of 341 individual cases of malignancy, four were suspected of recurrence during follow-up visits. Subsequently, all four cases were biopsied and confirmed histologically as cancer recurrence. All of the relapses originally had squamous cell carcinoma. None of the patients with basal cell carcinoma relapsed. The time frame for recurrence varied between 3 to 18 months after the final treatment visit. All four cases of recurrences were found in adult males, and the cancers were limited to the head and neck area. Conclusion: Cancer recurrence outcomes of persons treated with high-frequency ultrasound-guided SRT were comparable to those reported for surgical treatment of non-melanoma skin cancer. Further prospective studies with longer follow-up periods would be valuable to in assessing the risk of recurrences after SRT, and to refine treatment protocols to minimize treatment failures and tumor recurrence. This would improve patients’ ability to make informed decisions regarding their treatment options for non-melanoma skin cancer.

Original Publisher

HCA Healthcare Graduate Medical Education

Presentations of Tumor Recurrence of Non-Melanoma Skin Cancer After Treatment with Low-Energy Superficial Radiation Therapy



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