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Pezzulla D, Pastore F, Fionda B, Cellini F, Di Franco R, Ciabattoni A, Corazzi F, Cossa S, Dominici L, Draghini L, Gherardi F, Lillo S, Longo S, Mazzarotto R, Navarria F, Piccolo F, Stefanelli A, Vicenzi L, Zamagni A, Maranzano E, Tagliaferri L. Radiation Therapy in Non-Melanoma Skin Cancers: An Italian Survey on Behalf of the Italian Association of Radiotherapy and Clinical Oncology. Clin Oncol (R Coll Radiol) 2024:S0936-6555(24)00219-X. [PMID: 38971685 DOI: 10.1016/j.clon.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/24/2024] [Accepted: 06/11/2024] [Indexed: 07/08/2024]
Abstract
AIMS The National Palliative Care and Interventional Radiotherapy Study Groups of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) carried out a survey whose aim was to obtain a "snapshot" of the real-world practice of nonmelanoma skin cancer (NMSC) treatments in Italy. MATERIALS AND METHODS The survey was conducted on SurveyMonkey's online interface and was sent via e-mail to our society Radiation Oncologists. RESULTS Fifty-eight Italian radiation oncologists (ROs), representing 54 centers, answered the survey. Thirteen percent of the ROs declared they treat fewer than 10 NMSC lesions annually, 36% treat between 11 and 20, and 51% treat more than 20 lesions annually. Interventional radiotherapy (IRT) was offered by 25% of the ROs, and every case was reportedly discussed by a multidisciplinary team (71%). Electrons (74%), volumetric modulated arc therapy (V-MAT) (57%), three-dimensional conformal radiotherapy (3D-CRT) (43%), and IRT (26%) were the main treatment options. With external beam radiotherapy (EBRT), 46 and 53 different RT schedules were treated for curative and palliative intent, respectively; whereas for IRT, there were 21 and 7 for curative and palliative intent, respectively. The most popular EBRT curative options were 50-70.95/22-35 fractions (fx) and 50-70 Gy/16-20fx and for EBRT palliative settings, 30Gy/10fx, and 20-35Gy/5fx. For IRT, the most popular curative options were 32-50Gy/8-10fx and 30-54Gy/3-5fx, whereas 30Gy/6fz was the palliative option. Less than 10 re-RT cases were reported in one year in 42.5%, 11-20 cases in 42.5%, and >20 cases annually in 15%. Electrons (61%), VMAT (49%), and BRT (25%) were the most widely used approaches: 20-40Gy in 10fx and 20-25Gy in 5fx were the recommended fractionations. CONCLUSION The survey shows a variegated reality. A national registry with more detailed data could help in undercover its causes.
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Affiliation(s)
- D Pezzulla
- Radiation Oncology Unit, Responsible Research Hospital, Italy
| | - F Pastore
- Dipartimento di Diagnostica Per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, Italy
| | - B Fionda
- Dipartimento di Diagnostica Per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, Italy.
| | - F Cellini
- Dipartimento di Diagnostica Per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, Italy
| | - R Di Franco
- Department of Radiation Oncology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Italy
| | - A Ciabattoni
- UOC Radioterapia, Ospedale San Filippo Neri, ASL Roma 1, Italy
| | - F Corazzi
- S.C. Radioterapia aziendale USL Umbria1 Ospedale Città di Castello (PG), Italy
| | - S Cossa
- UOC Radioterapia, Fondazione "Casa Sollievo della Sofferenza," IRCCS, S. Giovanni Rotondo, Foggia, Italy
| | - L Dominici
- Department of Radiotherapy, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy
| | - L Draghini
- Radiation Oncology Centre, S Maria Hospital, Terni, Italy
| | - F Gherardi
- Department of Radiation Oncology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Italy
| | - S Lillo
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - S Longo
- Dipartimento di Diagnostica Per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, Italy
| | - R Mazzarotto
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Integrata, 37124 Verona, Italy
| | - F Navarria
- Radiation Oncology Department, National Cancer Institute (CRO)- IRCCS, Aviano, Italy
| | - F Piccolo
- SC di Radioterapia Ospedale di Circolo Fondazione Macchi, Varese, Italy
| | - A Stefanelli
- Operational Unit of Oncological Radiotherapy, St Anna University Hospital of Ferrara, Italy
| | - L Vicenzi
- Radiation Oncology, Fondazione Policlinico Universitario Campus Biomedico, Italy
| | - A Zamagni
- Radiation Oncology, Department of Experimental Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum-Bologna University, Italy
| | - E Maranzano
- Former Full Professor of Radiation Oncology, University of Perugia, Italy
| | - L Tagliaferri
- Dipartimento di Diagnostica Per Immagini, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, Italy
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Suzuki G, Machida K, Asato A, Seri S, Ikemoto C, Yamazaki H, Yamada K, Katsumori T. Definitive Radiotherapy for Penoscrotal Extramammary Paget's Disease: A Case Report with Long-Term Follow-Up. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2021; 14:11795476211009251. [PMID: 33953632 PMCID: PMC8042548 DOI: 10.1177/11795476211009251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/22/2021] [Indexed: 11/17/2022]
Abstract
Penoscrotal extramammary Paget's disease (EMPD) is a rare intraepithelial adenocarcinoma in older male patients, and no effective nonsurgical treatment strategies are currently available. The aim of this study was to report the usefulness of external radiotherapy (RT) for penoscrotal EMPD in an inoperable elderly patient. This report presents the treatment of an 89-year-old man with widespread penoscrotal EMPD. A multidisciplinary treatment team decided on radical RT. The patient received a radiation dose of 61.8 Gy in 30 fractions through electron and photon beams. His treatment tolerance was good, and no severe toxicity had been observed up the last follow-up. At 6.5 years after the RT, the patient showed no evidence of recurrence. Definitive RT resulted in excellent disease control and minimal toxicity; thus, it could be a promising nonsurgical therapeutic option for penoscrotal EMPD, even in extremely elderly individuals.
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Affiliation(s)
- Gen Suzuki
- Department of Radiology, Saiseikai Shiga Hospital, Ritto, Shiga, Japan
- Department of Radiology, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
| | - Kazutaka Machida
- Department of Radiology, Saiseikai Shiga Hospital, Ritto, Shiga, Japan
| | - Akito Asato
- Department of Radiology, Saiseikai Shiga Hospital, Ritto, Shiga, Japan
| | - Sho Seri
- Department of Radiology, Saiseikai Shiga Hospital, Ritto, Shiga, Japan
| | - Chika Ikemoto
- Department of Dermatology, Saiseikai Shiga Hospital, Ritto, Shiga, Japan
| | - Hideya Yamazaki
- Department of Radiology, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
| | - Kei Yamada
- Department of Radiology, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
| | - Tetsuya Katsumori
- Department of Radiology, Saiseikai Shiga Hospital, Ritto, Shiga, Japan
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