PMID- 37806558 OWN - NLM STAT- MEDLINE DCOM- 20231128 LR - 20231204 IS - 1879-0887 (Electronic) IS - 0167-8140 (Linking) VI - 189 DP - 2023 Dec TI - Salvage re-irradiation in non-melanoma skin cancers: A multicenter analysis. PG - 109945 LID - S0167-8140(23)89839-5 [pii] LID - 10.1016/j.radonc.2023.109945 [doi] AB - BACKGROUND AND PURPOSE: We conducted a multicentre real-world study to assess the outcomes of radical salvage re-irradiation for non-melanoma skin cancer (nMSC) recurrences following definitive or postoperative radiotherapy. MATERIALS AND METHODS: Data on patients treated between 2006 and 2022 with re-irradiation for nMSCs were retrospectively collected from five high-volume brachytherapy centers. The primary endpoint was local control (LC). Secondary endpoints included overall survival, progression-free survival, and adverse events (AEs). The Kaplan-Meier estimator and Cox Proportional-Hazards Model were utilised in the analysis. RESULTS: A total of 58 patients with a median age of 78.4 years with recurrences of previously irradiated nMSC in the head and neck region were included in the analysis. The majority had cutaneous basal cell carcinoma (BCC; 91.4%), and were irradiated with high-dose-rate brachytherapy (HDR-BT; 91.4%). The most common locations included the nasal region (36.2%) and external ear (18.9%). The 1-year LC was 73.1% and decreased to 41.7% at three years. The size of the re-irradiated lesion was the single independent prognostic factor in Cox analysis (per mm; HR 1.07; 95% CI 1.04-1.11; p < 0.001). Grade 3 or worse AEs were reported in 7 cases (12.1%). CONCLUSION: Re-irradiation for nMSCs, predominantly administered with brachytherapy for radiorecurrent BCC, is associated with high recurrence rates, and the risk of failure significantly increases with the size of the treated lesion. Re-irradiation could be an option for selected elderly patients with small, localised, inoperable recurrences after RT to achieve local control or defer systemic treatment; however, prospective trials are necessary to confirm its safety and efficacy. CI - Copyright (c) 2023 The Author(s). Published by Elsevier B.V. All rights reserved. FAU - Miszczyk, Marcin AU - Miszczyk M AD - IIIrd Radiotherapy and Chemotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland; Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Wahringer Gurtel 18-20, 1090 Vienna, Austria. Electronic address: marcin.miszczyk@io.gliwice.pl. FAU - Suleja, Agata AU - Suleja A AD - IIIrd Radiotherapy and Chemotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland; II Department of Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology Warsaw Branch, Wawelska 15/B, 00-001 Warszawa, Poland. FAU - Sobel, Szymon AU - Sobel S AD - IIIrd Radiotherapy and Chemotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. FAU - Stec, Maria AU - Stec M AD - IIIrd Radiotherapy and Chemotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. FAU - Chyrek, Artur Jan AU - Chyrek AJ AD - Brachytherapy Department, Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland; Electroradiology Department, Poznan University of Medical Sciences, Garbary 15, 61-866 Poznan, Poland. FAU - Kolbusz, Miroslaw AU - Kolbusz M AD - Brachytherapy Department, Subcarpathian Cancer Center, ks Bielawskiego 18, 36-200 Brzozow, Poland. FAU - Spalek, Mateusz AU - Spalek M AD - II Department of Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology Warsaw Branch, Wawelska 15/B, 00-001 Warszawa, Poland. FAU - Nasiek, Aleksandra AU - Nasiek A AD - IIIrd Radiotherapy and Chemotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. FAU - Stankiewicz, Magdalena AU - Stankiewicz M AD - Brachytherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. FAU - Lelek, Piotr AU - Lelek P AD - Brachytherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. FAU - Moll, Matthias AU - Moll M AD - Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Wahringer Gurtel 18-20, 1090 Vienna, Austria. FAU - Kluska, Adam AU - Kluska A AD - Brachytherapy Department, Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland. FAU - Kazalski, Damian AU - Kazalski D AD - Brachytherapy Department, Subcarpathian Cancer Center, ks Bielawskiego 18, 36-200 Brzozow, Poland. FAU - Saniewski, Piotr AU - Saniewski P AD - II Department of Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology Warsaw Branch, Wawelska 15/B, 00-001 Warszawa, Poland. FAU - Kaminiow, Konrad AU - Kaminiow K AD - IIIrd Radiotherapy and Chemotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland; Clinical Department of Internal Diseases, Dermatology and Allergology in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland. FAU - Burchardt, Wojciech Maria AU - Burchardt WM AD - Brachytherapy Department, Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland; Electroradiology Department, Poznan University of Medical Sciences, Garbary 15, 61-866 Poznan, Poland. FAU - Wojcieszek, Piotr AU - Wojcieszek P AD - Brachytherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. FAU - Chichel, Adam AU - Chichel A AD - Brachytherapy Department, Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland. FAU - Cichon, Piotr AU - Cichon P AD - Brachytherapy Department, Subcarpathian Cancer Center, ks Bielawskiego 18, 36-200 Brzozow, Poland. FAU - Krzysztofiak, Tomasz AU - Krzysztofiak T AD - Brachytherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20231006 PL - Ireland TA - Radiother Oncol JT - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology JID - 8407192 SB - IM MH - Humans MH - Aged MH - *Re-Irradiation/adverse effects MH - Retrospective Studies MH - *Head and Neck Neoplasms/radiotherapy/etiology MH - Prospective Studies MH - Neoplasm Recurrence, Local/pathology MH - *Skin Neoplasms/radiotherapy MH - *Brachytherapy/adverse effects MH - Salvage Therapy OTO - NOTNLM OT - MeSH Unique ID: D016896 OT - MeSH Unique ID: D018295 OT - MeSH Unique ID: D018307 OT - MeSH terms: MeSH Unique ID: D011878 OT - Neoplasms, Basal Cell OT - Neoplasms, Squamous Cell OT - Radiotherapy OT - Re-Irradiation OT - Treatment Outcome COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2023/10/09 00:41 MHDA- 2023/11/28 06:42 CRDT- 2023/10/08 19:30 PHST- 2023/07/17 00:00 [received] PHST- 2023/09/24 00:00 [revised] PHST- 2023/09/30 00:00 [accepted] PHST- 2023/11/28 06:42 [medline] PHST- 2023/10/09 00:41 [pubmed] PHST- 2023/10/08 19:30 [entrez] AID - S0167-8140(23)89839-5 [pii] AID - 10.1016/j.radonc.2023.109945 [doi] PST - ppublish SO - Radiother Oncol. 2023 Dec;189:109945. doi: 10.1016/j.radonc.2023.109945. Epub 2023 Oct 6.