Image-Guided Superficial Radiation Therapy Yields Superior 2-Year Recurrence Rates Compared to Mohs Micrographic Surgery, Cancer Journal Reports

02 Oct 2023
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Radiation TherapyClinical Study
Represents a "seminal moment in the care of skin cancer patients"
BURR RIDGE, Ill., Oct. 2, 2023 /PRNewswire/ -- SkinCure Oncology, the world leader in providing a comprehensive model for the delivery of Image-Guided Superficial Radiation Therapy (Image-Guided SRT, or IGSRT), today announced a newly published study revealing that IGSRT technology is superior to Mohs micrographic surgery (MMS). Image-Guided SRT is the most advanced nonsurgical treatment for common skin cancers. This peer-reviewed study "supports IGSRT as an effective treatment option for individuals with early stage NMSCs (nonmelanoma skin cancers)." The study is the first to directly compare two-year recurrence probabilities of Image-Guided SRT to Mohs.
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The report, entitled, "Image-guided superficial radiation therapy has superior 2-year recurrence probability to Mohs micrographic surgery," appears in the journal Clinical and Translational Radiation Oncology, which is published by the European Society for Radiotherapy & Oncology (ESTRO). The authors are Erin M. McClure, B.S., University of South Florida Morsani College of Medicine; Geoffrey Sedor, M.D., Columbia University Irving Medical Center, Vagelos College of Physicians & Surgeons; Yuxuan Jin, M.S., Cleveland Clinic, Department of Quantitative Health Sciences; and Michael W. Kattan, Ph.D., Cleveland Clinic, Department of Quantitative Health Sciences. A poster presentation on the research is featured at the American Society for Radiation Oncology (ASTRO) annual meeting in San Diego this week.
"The major finding…is a big win for the modern-day Mohs surgeon and the dermatology profession." Dr. Daniel J. Ladd, Jr.
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Dr. Daniel J. Ladd, Jr., Mohs surgeon and Chief Medical Officer of SkinCure Oncology, said, "The major finding demonstrating a statistically significant improvement in 2-year recurrence probabilities of NMSCs when treated primarily with IGSRT compared to MMS, is a big win for the modern-day Mohs surgeon and the dermatology profession. This was observed both in pooled NMSC data and when stratified by histological type ((basal cell carcinoma (BCC), squamous cell carcinoma (SCC)). This suggests that IGSRT should become a first-line recommendation for patients with early stage NMSCs, like BCCs and SCCs, particularly for individuals who are poor candidates for, or who refuse surgical resection. As a physician, having Image-Guided SRT and Mohs micrographic surgery for patients allows me to offer a comprehensive approach to fully informed consent and medical decision making. After all, it is all about our patients."
The retrospective cohort study compared the 2-year recurrence probability of early stage NMSCs treated by IGSRT (2,286 lesions) to data on NMSCs treated by MMS (5,391 lesions) via one sample proportion tests. Medical Subject Headings were used to search PubMed for reports of 2-year recurrence probability rates of NMSCs treated by MMS.
The authors highlight the following advantages of IGSRT:
It is well tolerated;
Each procedure visit is relatively short (visits are 10-15 minute per lesion, with the treatment itself lasting less than a minute, compared to a typical Mohs session of 2-4 hours);
IGSRT results in favorable cosmetic outcomes; reconstructive/scar revision procedures are avoided and it eliminates post-surgical complications;
It is an option for patients with contraindications to surgery, like certain cardiac conditions or coagulopathies; and,
Treatment with IGSRT, which is performed by a radiation therapist with physician supervision, can include up to four lesions at one time, and is not constrained by anatomy.
"Because IGSRT is noninvasive," Dr. Ladd notes, "it results in favorable cosmetic outcomes with no scarring or need for reconstructive surgery. As reported, this is particularly important, as the greatest incidence of NMSC occurs on sun-exposed areas such as the head and neck, which are cosmetically sensitive."
The authors underscore that National Comprehensive Cancer Network squamous cell carcinoma guidelines state that "all treatment decisions should be customized to account for the particular factors present in the individual case and for the patient's preference." Therefore, the authors note, radiation therapy such as IGSRT is an effective treatment option for patients who refuse surgery and where maximal preservation of function and cosmesis is considered.
The journal article concludes, "In this analysis IGSRT outperforms MMS in the treatment of NMSCs as determined by a statistically significantly superior 2-year recurrence probability. There is a subset of patients (those who refuse MMS, have contraindications to surgery, or prefer the toxicity profile of IGSRT) where this is a unique and advantageous treatment modality. It is important to provide patients as many effective treatment options as possible. Patients should be empowered to participate in their treatment course during the full informed consenting process, which affirms the patient's role in the decision-making process. The data in this study is compelling and supports the continued practice, and expansion of IGSRT."
Dr. Ladd added, "As this is the first head-to-head comparison of the novel IGSRT technology to MMS, it represents a seminal moment in the care of skin cancer patients using radiation."
Nonmelanoma skin cancer is the most commonly diagnosed cancer in the United States. In 2012, there were 5.4 million cases, with incidence increasing about two percent annually, and with roughly 2,000 deaths per year resulting.
The authors observe that prior to the invention of Mohs surgery, superficial radiation therapy (SRT) was a standard therapy offered by dermatologists for nonmelanoma skin cancer. It offered excellent toxicity profiles and, at the time, equivalent oncologic outcomes to resection. With the advent of Mohs, however, SRT oncologic outcomes fell significantly behind, and SRT fell out of favor. IGSRT was developed in 2016, and since then, this technology and treatment paradigm has seen a resurgence. Initial results have suggested outcomes that are far improved over SRT, warranting the currently-reported robust statistical comparison of IGSRT to Mohs.
SkinCure Oncology is the world leader in providing a comprehensive model for the delivery of Image-Guided Superficial Radiation Therapy (Image-Guided SRT), the most advanced nonsurgical treatment for common skin cancer. The company partners with quality-focused dermatologists, Mohs surgeons and other physicians to bring cancer center-level radiation therapy treatment to private practices. Presented to patients as the GentleCure™ experience, Image-Guided SRT is available from some 500 physicians nationwide, with more than 65,000 patients having been successfully treated. Learn more about the company at SkinCureOncology.com, and visit GentleCure.com for helpful consumer and patient information.
Media Contact:
Bill Sklar
Russell Public Communications
520-979-9400
[email protected]
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