Radiation Therapy in Non-Melanoma Skin Cancers: An Italian Survey on Behalf of the Italian Association of Radiotherapy and Clinical Oncology

Donato Pezzulla,Francesco Pastore,Bruno Fionda,Francesco Cellini,Rossella Di Franco,Antonella Ciabattoni,Francesca Corazzi,Sabrina Cossa,Luca Dominici,Lorena Draghini,Federica Gherardi,Sara Lillo,Silvia Longo,Renzo Mazzarotto,Federico Navarria,Federica Piccolo,Antonio Stefanelli,Lisa Vicenzi,Alice Zamagni,Ernesto Maranzano,Luca Tagliaferri

doi:10.1016/j.clon.2024.06.006

Abstract

AimsThe 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 methodsThe survey was conducted on SurveyMonkey's online interface and was sent via e-mail to our society Radiation Oncologists. ResultsFifty-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. ConclusionThe survey shows a variegated reality. A national registry with more detailed data could help in undercover its causes.

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