Recent findings from the Dermatology Association of Radiation Therapy (DART) have shed light on the promising role of image-guided superficial radiation therapy (IGSRT) in treating nonmelanoma skin cancer (NMSC). This expert panel’s analysis, published in SKIN The Journal of Cutaneous Medicine in January 2025, reinforces IGSRT as a viable first-line treatment option for select NMSC cases.1
squamous cell carcinoma on the face | Image Credit: © DermNet
Key Insights from the expert Panel
Table of Contents
The expert panel reached a consensus on the effectiveness and safety of IGSRT, issuing ten guiding statements for its submission. A important conclusion is that IGSRT can serve as an effective first-line treatment for NMSC when appropriately selected for patients.
Consensus Recommendations Highlighted
The panel confirmed that IGSRT is a safe and effective treatment for NMSC, boasting high cure rates and the advantage of real-time imaging to assess tumor characteristics. The integration of ultrasound guidance enhances the precision of radiation delivery, making it especially beneficial for tumors in complex anatomical locations.
Recognized as a first-line treatment option, IGSRT presents a compelling alternative to traditional methods such as Mohs surgery and cryotherapy, especially for patients who may not be ideal candidates for these procedures.
A notable advantage of IGSRT is its potential for favorable cosmetic outcomes. The panel emphasized that for patients concerned about post-treatment appearance, IGSRT may be the preferred choice, particularly for tumors in cosmetically sensitive areas like the face and ears, where minimizing scarring is essential.
In alignment with DART’s mission, the panel stressed the importance of patient involvement in treatment decisions. The choice of IGSRT should follow comprehensive discussions about all available options, considering individual patient preferences, tumor histology, and other relevant factors such as age and comorbidities.
The panel unanimously agreed that dermatologists are best suited to administer and oversee IGSRT for NMSC, given their expertise in skin cancer management, which allows for the integration of radiation therapy into comprehensive treatment plans.
Moreover,the panel concluded that IGSRT offers superior outcomes compared to traditional electron beam radiation therapy for NMSC,reinforcing its status as a modern and effective tool in dermatologic oncology.
While the panel strongly supports IGSRT, they acknowledged that it may not be suitable for all patients. for those with aggressive tumor types or specific health conditions that contraindicate radiation, alternative therapies may be more appropriate.
Looking Ahead: The Future of IGSRT
Dr. Deborah sarnoff, a contributor to the panel and president of The Skin Cancer Foundation, highlighted the necessity of exploring all treatment options, especially for patients who are unable or unwilling to undergo surgery.
Given our institution’s commitment to empowering people to be proactive in their approach to prevention, early detection, and treatment of skin cancer, I am proud to have participated in this thoughtful, scientifically sound evaluation of the literature on IGSRT, which offers promise for those diagnosed with NMSC who are unwilling or unable to undergo Mohs surgery.
— Dr. Deborah sarnoff
DART Chairman Dr. Jacob Scott echoed this sentiment, emphasizing the importance of providing patients with clear, evidence-based guidance.
The expert panel did a superb job analyzing the existing research and providing critical guideposts for the use of IGSRT in dermatology practices.Of particular value is their highlighting of those cases in which IGSRT can be considered optimal as first-line therapy for NMSC, as well as cases in which it is not recommended or contraindicated.
— Dr. Jacob Scott
Reference
- In journal SKIN, expert dermatology panel reports image-guided superficial radiation therapy safe & effective, and a first-line treatment option in selected cases of nonmelanoma skin cancer. News release. PR Newswire. February 12, 2025. Accessed February 20,2025. https://www.prnewswire.com/news-releases/in-journal-skin-expert-dermatology-panel-reports-image-guided-superficial-radiation-therapy-safe–effective-and-a-first-line-treatment-option-in-selected-cases-of-nonmelanoma-skin-cancer-302375055.html
- Zakria D, Burshtein J, Shah M, et al. The role of image-guided superficial radiation therapy in the treatment of nonmelanoma skin cancer. J Cutan Med. 9, 1 (Jan. 2025), 2042–2054.
Image-Guided Superficial Radiation Therapy (IGSRT): A New Era in Nonmelanoma Skin Cancer Treatment? An Expert Weighs In
Time.news: Welcome, Dr. Anya Sharma, and thank you for joining us today.Recent news highlights a consensus from the Dermatology Association of Radiation Therapy (DART) regarding Image-Guided superficial Radiation Therapy, or IGSRT, as a first-line treatment for select Nonmelanoma Skin Cancer (NMSC) cases. Can you explain what IGSRT is and why this announcement is significant?
Dr.Sharma: Thank you for having me. IGSRT is a form of radiation therapy that uses real-time imaging,typically high-resolution ultrasound,to guide the delivery of radiation to nonmelanoma skin cancers. This precision is key. The meaning of the DART panel’s findings,published in SKIN The Journal of Cutaneous Medicine,lies in its confirmation by experts that IGSRT is not just a viable option,but a first-line treatment for appropriately selected patients with NMSC.
Time.news: What does this mean for patients currently undergoing or considering treatment for NMSC?
Dr. Sharma: It means that IGSRT is gaining broader recognition and acceptance within the dermatology community. Patients now have another evidence-backed option to discuss with their dermatologists. The panel emphasized that IGSRT is a safe and effective treatment, boasting high cure rates. This is particularly important for those who may not be ideal candidates for traditional methods like Mohs surgery or cryotherapy.
Time.news: The article emphasizes favorable cosmetic outcomes with IGSRT. Can you elaborate?
Dr. Sharma: Absolutely. one of the most compelling advantages of IGSRT is its potential to minimize scarring. The radiation is delivered precisely to the tumor, sparing surrounding healthy tissue. For tumors located in cosmetically sensitive areas, such as the face and ears, this can be a major advantage. Many patients are understandably concerned about post-treatment appearance, and IGSRT offers a way to address their cancer while prioritizing aesthetics.
Time.news: The DART panel also suggests that dermatologists are best suited to oversee IGSRT. Why is that?
Dr. Sharma: Dermatologists are experts in diagnosing and managing skin cancer. They possess a deep understanding of skin histology, tumor behavior, and various treatment modalities. This expertise allows them to integrate IGSRT seamlessly into a thorough treatment plan, considering the individual patient’s needs and preferences. The panel also made a point to say IGSRT may provide superior outcomes to tradional electron beam therapies for NMSC.
Time.news: What factors determine whether IGSRT is “appropriately selected” for a patient?
Dr. Sharma: Several factors come into play. These include the type and location of the NMSC,the patient’s overall health,their age,and any other existing medical conditions. patient involvement is paramount; the decision should be made after in-depth discussions about all treatment options, and how well you can keep up with a treatment plan.
Time.news: Are there any cases where IGSRT is not recommended?
Dr. Sharma: Yes. The panel acknowledged that IGSRT may not be suitable for all patients. Those with aggressive tumor types or health conditions that contraindicate radiation may require choice therapies.It’s crucial to remember that IGSRT isn’t a one-size-fits-all solution, and a thorough evaluation is essential.
Time.news: What practical advice would you give to someone newly diagnosed with nonmelanoma skin cancer?
Dr. Sharma: First, don’t panic. NMSC is highly treatable. Second, seek out a qualified dermatologist for a comprehensive evaluation and individualized treatment plan. Be sure to ask about all available options, with the traditional methods of cancer treatment, as well as alternatives like IGSRT: understand the potential benefits and risks of each. patient education is key to making informed decisions. Actively participate in the treatment planning process, and don’t hesitate to ask questions.[2, 3]
Time.news: Dr. Sharma, thank you for sharing your insights on IGSRT and its role in the future of nonmelanoma skin cancer treatment.
Dr. sharma: My pleasure. It’s important that patients are aware of these advancements and feel empowered to discuss them with their healthcare providers.