Abstract：
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.
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.
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%).
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.
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.
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%).
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.
摘要：
目的：我们进行了一项多中心的真实世界研究，以评估非黑色素瘤皮肤癌（nMSC）在确定性或术后放疗后复发的根治性挽救性再放疗的结果。
方法：回顾性地从5个大容量近距离放射治疗中心收集了2006年至2022年间接受nMSCs再照射治疗的患者的数据。主要终点是局部控制（LC）。次要终点包括总生存期，无进展生存期,和不良事件（AE）。在分析中使用了Kaplan-Meier估计和Cox比例风险模型。
结果：共58例患者，中位年龄为78.4岁，先前接受过照射的nMSC在头颈部复发。大多数患有皮肤基底细胞癌（BCC；91.4％），并接受高剂量率近距离放射治疗（HDR-BT;91.4％）。最常见的部位包括鼻部（36.2%）和外耳（18.9%）。1年LC为73.1%，3年降至41.7%。再次照射的病灶大小是Cox分析中的独立预后因素(每mm;HR1.07;95%CI1.04-1.11;p<0.001)。7例（12.1%）报告3级或更严重的不良事件。
结论：再次照射nMSCs，主要采用近距离放射治疗治疗放射治疗复发性BCC，与高复发率相关，失败的风险随着治疗病灶的大小而显著增加。重新照射可能是选择老年患者的一种选择，本地化,放疗后无法手术复发，无法实现局部控制或推迟全身治疗；然而，有必要进行前瞻性试验以确认其安全性和有效性.
方法：回顾性地从5个大容量近距离放射治疗中心收集了2006年至2022年间接受nMSCs再照射治疗的患者的数据。主要终点是局部控制（LC）。次要终点包括总生存期，无进展生存期,和不良事件（AE）。在分析中使用了Kaplan-Meier估计和Cox比例风险模型。
结果：共58例患者，中位年龄为78.4岁，先前接受过照射的nMSC在头颈部复发。大多数患有皮肤基底细胞癌（BCC；91.4％），并接受高剂量率近距离放射治疗（HDR-BT;91.4％）。最常见的部位包括鼻部（36.2%）和外耳（18.9%）。1年LC为73.1%，3年降至41.7%。再次照射的病灶大小是Cox分析中的独立预后因素(每mm;HR1.07;95%CI1.04-1.11;p<0.001)。7例（12.1%）报告3级或更严重的不良事件。
结论：再次照射nMSCs，主要采用近距离放射治疗治疗放射治疗复发性BCC，与高复发率相关，失败的风险随着治疗病灶的大小而显著增加。重新照射可能是选择老年患者的一种选择，本地化,放疗后无法手术复发，无法实现局部控制或推迟全身治疗；然而，有必要进行前瞻性试验以确认其安全性和有效性.
