The Effect Of Superficial X-ray Irradiation On Non-melanoma Skin Cancer

Objective:To study the efficacy and feasibility of superficial X-ray irradiation in the treatment of non-melanoma skin cancer.Method: To retrospectivelyanalyze the clinical data of patients with non-melanoma skin cancer(SCC、BCC and extrammary paget disease)who have been definitivelydiagnosed with definitively by pathological examination and could not receive surgical resection due to various reasonsin in our hospital from April 2017 to April 2019.A total of 65 patients with non-melanoma skin cancer were enrolled,45 cases were assigned into the experimental group who receivedsuperficial X-ray irradiation therapy,20 into the control group who received photodynamic therapy.Treatment was completed within 3 months in both groups.Treatment duration,healing time,efficiency,cure rate and pain index wereevaluated.Results: The average treatment time was 4.56 ± 0.35 weeks and 10.50± 0.59 weeks,the healing time of skin lesions was 62.23 ± 4.42 days and 85.91 ± 9.23 days in the experimental group and the control group respectively.In the experimental group,theeffective rate was 66.67%,100%,and 100%in the first,third,and sixth monthsrespectively,and the cure rate was 24.44%,88.89%,and 95.56%respectively.In the control group,the effective rate was 25%,75%,and 75%,and the cure rate was0,50%,and 55%respectively.There was a significantdifference between the two groups statistically on the average treatment time,the healing time,theeffective rate and the cure rate(P<0.05).In the experimental group,the larger the range of the lesions was,the more the frequency of irradiation,and the higher the total treatment dose were.For the lesions whose diameter was 2cm or less,the average number of irradiation was 8.5 ± 2.95,the averageirradiationdose was 36 ± 10.04 Gy.For the lesions whose diameter was more than 2cm,and less than or equal to 4cm,the average number of irradiation was 10.58±2.38,the averageirradiationdose was 45.69±14.04 Gy,andforlesions whose diameter was larger than 4cm,the average number of irradiation was 12,and the averageirradiationdose was 49.5±15.22 Gy.The effect of superficial X-ray irradiation on SCC is significantly better than photodynamic therapystatistically(P<0.05).For patients with BCC,the rash healing time in the experimental group was significantly shorter than that in the control group(P<0.05)。The pain index score was 0.4±0.94 during the treatmentin the experimental group,and was 4.05±1.36 in the control group.There were statistical differences between the groups(P<0.05).During follow-up,one case with extrammary paget disease in the experimental group relapsed 8 months after treatment,with a recurrence rate of 2.22%.Two casesin the control group relapsed,with a recurrence rate of 10%,of which one with extrammary paget disease relapsed 6 months after treatment,and the other with SCC relapsed14 months after treatment.Conclusion: Compared with photodynamic therapy,the treatment time of superficial X-ray irradiation was shorter,the wound healing speed was faster,the effective rate and the cure rate within 6 months were higher,and the pain index score waslower,in treating patients with non-melanoma skin cancer which cannot be surgically removed(P<0.05).There was almost no pain during the superficial X-rayirradiation treatment.Therecurrence rate was also lower,and the incidence of other adverse reactions was low and the symptoms were mild.Thus superficial X-ray irradiation treatment of NMSC is safe and effective,which is worthy of clinical promotion.