Entity: Universitat Rovira i Virgili (URV)
Confidenciality: No
Education area(s): Envelliment i Salut
Title in different languages: Retrospective study in elderly patients with non-melanoma skin cancer treated with different radiotherapy techniques
Abstract: Background: Non-melanoma skin cancer (NMSC) is one of the most frequent cancers among the elderly population. There are different therapeutic options such as surgery, radiotherapy, cryotherapy, photodynamic therapy, therapy with intralesional interferon or various creams with topical chemotherapy drugs. The treatment decision will depend on different factors in relation to the tumor and the patient. Objectives: To demonstrate the utility of different radiotherapy techniques (brachytherapy, orthovoltage, and electron radiotherapy) for NMSC in patients over 80 years of age, in relation to local control and cosmesis. Methods: The sample is made up of a total of 183 patients with NMSC treated in the Radiation Oncology Service of the Hospital Universitari Sant Joan de Reus (HUSJR) between 2008 and 2014. It was an essential requirement to be over 80 years old. 21 variables were included: sex, age of diagnosis, histology of the tumor, histological grade, presence of infiltration, margin, mode of appearance of carcinoma, tumor size, the treated area, radiotherapy technique, intention of the treatment, total dose, number of sessions, fractionation of the dose, duration of the radiotherapy treatment, degree of acute and chronic toxicity, response to the treatment , appearance of recurrences and treatment used for it, and the current state of the patient. These data were analyzed with the SPSS statistical program. Results: 79.2% of participants were between 80 and 89 years old, 19.7% between 90 and 99 years old. The remaining 1.1% were over 100 years old. 60.1% were men and 54.1% were basal cell carcinomas, mostly of the infiltrating subtype. Of the 35% of which the histological grade was known, 13.1% was grade I, 17.5% grade II and 4.4% grade III. 54.6% had free tumor margins and 4.9% of the total cases had suffered an infiltration in other areas. 80.9% were newly emerging tumors, mostly located in the face area (48.1%) and smaller than 20 mm (53%). The most used technique for treatment was brachytherapy (BT) with a 40.4%, followed by orthovoltage with a 30.1%, and electron radiation therapy with a 29.5%. In 74.9%, the treatment was administered with radical intention. The response of each patient depends on the total dose administered, its fractionation, the total number of sessions performed and the toxicity, both acute and chronic, that can be generated. 92.3% of patients presented a complete response to treatment. Of the total participants, 15.9% are still alive and 83.5% died, 0.5% from oncological disease and the remaining 83% from other causes, who may or may not have NMSC. The remaining 0.5% was lost during therapeutic follow-up. Regarding acute toxicity, it was divided into: 21.3% of grade 1, 37.2% of grade 2, 36.6% of grade 3 and only 4.9% of grade 4. Therefore, regarding chronic toxicity, information was obtained from 82% of the carcinomas analyzed, divided into: 40.4% grade 0, 31.1% grade 1, 6% grade 2, 2.2 % of grade 3 and the same percentage of grade 4. Conclusion: Radiotherapy with its different techniques (BT, orthovoltage and with electrons) is an excellent alternative in patients with NMSC, with good local control and cosmetic.
Subject: Radioteràpia
Academic year: 2019-2020
Language: Castellà
Work's public defense date: 2020-07-03
Subject areas: Health sciences
Student: Canals Salvat, Maria
Department: Ciències Mèdiques Bàsiques
Creation date in repository: 2020-10-28
TFM credits: 12
Keywords: Radiotherapy, elderly, non-melanoma skin cancer
Title in original language: Estudio retrospectivo en pacientes de edad avanzada con cáncer de piel no melanoma tratados con diferentes técnicas de radioterapia
Project director: Arenas Prat, Meritxell
Repositori URV