Daily Imaging Boosts NMSC Treatment Success: Analysis

Image-guided superficial radiation therapy (IGSRT) was associated with a 99% cure rate for non-melanoma skin cancer (NMSC) when delivered with daily imaging, which allows for adaptive changes based on tumor depth fluctuations.

Researchers for a recent retrospective study looked at the role of daily imaging in enhancing the effectiveness of image-guided superficial radiation therapy (IGSRT) for non-melanoma skin cancer (NMSC). By integrating high-resolution dermal ultrasound (HRDUS) with superficial radiation therapy (SRT), the researchers said that IGSRT provides full dermal visualization that informs necessary adjustments during treatment, ensuring high cure rates and minimal toxicity.

The patient population was drawn from seven dermatology clinics (n = 1,507 cases of NMSC treated with IGSRT). According to the results, 92% of the lesions exhibited daily fluctuations in tumor depth, necessitating least one adaptive change in treatment for nearly 40% of the cases, with the remaining 60% requiring no adjustments.

Additionally, 83% of the lesions were classified as high-risk per the 2024 NCCN guidelines. The ability to visualize the entire dermis using HRDUS allowed clinicians to treat both low- and high-risk NMSC effectively, according to the paper. The authors emphasized that adaptive changes were essential in optimizing treatment efficacy and reducing potential toxicity.

"This study demonstrates that 92% of NMSC tumors undergoing IGSRT exhibit measurable changes in the depth of invasion compared to that of the previous image," the authors wrote. "Because these measurements are collected immediately prior to treatment, they allow the opportunity for adaptive changes in treatment parameters, such as kV, TDF, dose and boost. These adaptive changes are necessary in nearly 40% of cases, directly benefiting patients by maximizing efficacy and minimizing toxicity."

Source:  Stricker J, et al. Dermato. 2024;4(3):86-96. Doi:10.3390/dermato4030010