OBJECTIVE: In the ongoing absence of available trial data, a national survey was carried out to provide details on radiotherapy treatment strategy for non-melanoma skin cancer (NMSC). METHODS: A survey of clinical oncologists treating NMSC was performed. The respondents were asked for basic information on workload as well as a proposed treatment strategy for various clinical scenarios for patients of varying fitness. RESULTS: A total of 43 completed and 20 partially completed surveys were received. There was a wide variation in the workload and additional disease sites that respondents had responsibility for. Kilovoltage radiotherapy was available to 81% of responders. The respondents' approach was affected by the fitness of patients, with longer fractionation regimes proposed for younger, fitter patients and shorter or non-standard fractionations more likely for the infirm elderly. Four daily fractionation regimes (18-20 Gy in 1 fraction, 35 Gy in 5 fractions, 45 Gy in 10 fractions and 55 Gy in 20 fractions) were most commonly suggested. There was a large degree of variation in non-standard fractions proposed with significant potential differences in radiobiological effect. Concern over the use of kilovoltage photons on skin over cartilage was apparent, as was a reluctance to use radiotherapy in areas of increased risk of poor wound healing. CONCLUSION: The survey results largely showed practice to be in line with available published evidence. The variation seen in some areas, such as non-standard fractionation, would benefit from the publication of local outcomes to achieve a more consistent approach. ADVANCES IN KNOWLEDGE: This study provides information on national practices and identifies variations, particularly within widespread use of non-standard fractionation.
OBJECTIVE: In the ongoing absence of available trial data, a national survey was carried out to provide details on radiotherapy treatment strategy for non-melanoma skin cancer (NMSC). METHODS: A survey of clinical oncologists treating NMSC was performed. The respondents were asked for basic information on workload as well as a proposed treatment strategy for various clinical scenarios for patients of varying fitness. RESULTS: A total of 43 completed and 20 partially completed surveys were received. There was a wide variation in the workload and additional disease sites that respondents had responsibility for. Kilovoltage radiotherapy was available to 81% of responders. The respondents' approach was affected by the fitness of patients, with longer fractionation regimes proposed for younger, fitter patients and shorter or non-standard fractionations more likely for the infirm elderly. Four daily fractionation regimes (18-20 Gy in 1 fraction, 35 Gy in 5 fractions, 45 Gy in 10 fractions and 55 Gy in 20 fractions) were most commonly suggested. There was a large degree of variation in non-standard fractions proposed with significant potential differences in radiobiological effect. Concern over the use of kilovoltage photons on skin over cartilage was apparent, as was a reluctance to use radiotherapy in areas of increased risk of poor wound healing. CONCLUSION: The survey results largely showed practice to be in line with available published evidence. The variation seen in some areas, such as non-standard fractionation, would benefit from the publication of local outcomes to achieve a more consistent approach. ADVANCES IN KNOWLEDGE: This study provides information on national practices and identifies variations, particularly within widespread use of non-standard fractionation.
Authors: May N Tsao; Richard W Tsang; Fei Fei Liu; Tony Panzarella; Lorne Rotstein Journal: Int J Radiat Oncol Biol Phys Date: 2002-03-15 Impact factor: 7.038
Authors: Duc T Bui; Ashwin Chunilal; Babak J Mehrara; Joseph J Disa; Kaled M Alektiar; Peter G Cordeiro Journal: Ann Plast Surg Date: 2004-06 Impact factor: 1.539
Authors: Anna O Likhacheva; Phillip M Devlin; Shervin M Shirvani; Christopher A Barker; Phillip Beron; Ajay Bhatnagar; Stephen W Doggett; Lawrence Hochman; Charles Hsu; Michael Kasper; Martin Keisch; Subhakar Mutyala; Bradley Prestidge; Silvia Rodriguez Villalba; Vershalee Shukla; Srinath Sundararaman; Mitchell Kamrava Journal: Brachytherapy Date: 2016-11-28 Impact factor: 2.362