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John Evans

New radiation therapy guidelines for non-melanoma skin cancer



Superficial basal cell carcinoma. Photo by: U.S. Department of Health and Human Services

The Dermatology Association of Radiation Therapy (DART), a U.S. national non-profit medical society, has published new clinical guidelines for treating nonmelanoma skin cancer.


According to a press release, the guidelines were created collaboratively by members of the association's education and research committees to assist dermatologists, radiation oncologists, and radiation therapists in the appropriate use of noninvasive, radiation-based treatments for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).


The guidelines focus on appropriate use criteria for treating BCC and SCC using image-guided superficial radiation therapy (IGSRT), which combines high-resolution dermal ultrasound imaging with superficial radiation therapy. They offer detailed and distinct criteria for each of the two cancer types, including diagnosis, staging, and use of IGSRT, contraindications, rationale and protocol, follow-up, and more. The guidelines also emphasize that the need for a multidisciplinary team (MDT) is not only essential but central to the treatment protocol.


To optimize patient outcomes, the guidelines affirm that IGSRT should be delivered in the dermatology setting by a board-certified dermatologist with an MDT. The MDT must include a board-certified radiation therapist (RTT) for treatment delivery of IGSRT under the supervision of the prescribing dermatologist.


The MDT must also include access to a board-certified radiation oncologist and medical physicist and organized weekly national Grand Rounds to assist dermatologists with complex scenarios.


“We're absolutely committed to ensuring that all appropriate patients with nonmelanoma skin cancer have access to safe and effective, noninvasive, radiation-based treatments in the outpatient dermatology setting and that those undergoing treatment receive quality care in accordance with the latest evidence-based research and best practice standards of care,” DART President and Chairman Jacob Scott, MD, DPhil, DABR, said in the release. “When delivered in accordance with these evidence-based guidelines, IGSRT is shown to be safe and up to 99 per cent effective at eradicating these cancers.”

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