Short Course Radiation Best Longer Courses in Older Skin Cancer Patients

Shorter courses of radiation seem to be better than longer ones for older patients receiving treatment for basal and squamous cell skin cancers, a recent Penn State College of Medicine physician’s study review suggests.

To reduce the risk of long-term damage, the standard approach to radiation therapy has been small, daily doses over the course of weeks. But this drawn-out therapy can be costly and is inconvenient, especially for elderly patients who may have transportation or mobility issues.

In a new systematic review and meta-analysis, Nicholas G. Zaorsky, MD and colleagues looked at 21 international studies of radiation treatment for slow-growing skin cancers published between 1986 and 2016. The studies included almost 10,000 patients aged 62 to 84 years old who were followed up for anywhere from a year to more than six years after their therapy ended.

The researchers found no difference in long-term cosmetic outcomes between shorter- and longer-course therapies. The most common types of long-term skin damage reported across the studies were discoloration and the appearance of spider veins. Skin cancer recurrence at the same site was rare among all the regimens, and there were no deaths related to the treatments.

Based on this, the researchers recommend short courses of five, seven or 15 treatments — all adding up to around the same amount of total radiation exposure — for patients over 70 years old, especially if they have trouble traveling for treatments. Younger patients who are 60-70 years old can also consider these regimens, but they may live to see more skin damage from the treatments.

The meta-analysis has been published in the journal Radiotherapy and Oncology.