Treatment Recommendations among Radiation Oncologists in the Treatment of Cutaneous Squamous Cell Carcinoma with Perineural Invasion
| Autor: | Seesha R. Takagishi, Anokhi Jambusaria-Pahlajani, Jay J. Liao, Madhu Shetti, Marvin Heyboer, Upendra Parvathaneni, Stephen D. Hess, George E. Laramore, Daniel Berg, Chrysalyne D. Schmults |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Cutaneous squamous cell carcinoma business.industry medicine.medical_treatment Perineural invasion Surgery Radiation therapy 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Port (medical) Lower threshold 030220 oncology & carcinogenesis Internal medicine medicine Head and neck business |
| Zdroj: | Journal of Cancer Therapy. :824-835 |
| ISSN: | 2151-1942 2151-1934 |
| DOI: | 10.4236/jct.2016.711082 |
| Popis: | Purpose: Post-operative radiotherapy (PORT) for resected cutaneous squamous cell carcinoma (CSCC) with perineural invasion (PNI) is controversial. Therefore, we conducted a survey to review treatment recommendations among Radiation Oncologists (ROs) in the management of CSCC with PNI. Materials & Methods: In March 2011, we contacted all ROs and trainees in the US through email addresses listed in the 2009 ASTRO directory. Our web-based survey presented clinical vignettes involving Mohs micrographically resected CSCC with microscopic PNI (mPNI) or clinical PNI (cPNI). For each vignette, ROs were asked to indicate if PORT was appropriate and to further specify the dose and volume to treat. Results: Three hundred fifty two responses were completed and analyzed. The majority of ROs (72%) had over 10 years of post residency experience. 64% of the sampled ROs had a special interest in treating head and neck cancers, and 64% treated 4 or more cases per year. Approximately 95% recommended PORT for cPNI whereas 59% recommended PORT for mPNI. Post residency experience (10+ yrs vs. = 0.005) and for mPNI of deep subcutaneous non-named nerve involvement (80% vs. 60%, p = 0.001). ROs treating 8 or more cases per year (vs. = 0.01). Conclusions: Our study demonstrates significant variability among ROs in the management of CSCC with mPNI. For cases of cPNI, an overwhelming majority recommended PORT. In cases of mPNI, there was no consensus for recommending PORT, although experienced practitioners had a lower threshold for offering treatment. These results indicate the need for prospective clinical studies to clarify the role of PORT in CSCC patients with mPNI. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|