Reflectance confocal microscopy may be most effective at guiding radiation in BCC
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Reflectance confocal microscopy was more effective than dermoscopy or high-frequency ultrasonography in guiding radiation treatment in a small cohort of patients with basal cell carcinoma, according to a study.
“Radiation therapy (RT) is a treatment option for select skin cancers,” Cristian Navarrete-Dechent, MD, of the department of dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, and colleagues wrote. “The histologic effects of RT on normal skin or skin cancers are not well characterized.”
They suggested that RT response may be characterized by a number of noninvasive imaging methods, including dermoscopy, high-frequency ultrasonography (HFUS) and reectance confocal microscopy (RCM).
In the study involving 137 imaging assessments from 12 patients, the objective was to describe the impact of RT on the tumor and surrounding skin in basal cell carcinoma (BCC).
Patients with biopsy-confirmed BCCs were accrued between 2014 and 2018. Treatment protocols called for 42 Gy in six fractions. The mean age of patients in the cohort was 77 years. Ten of the 12 patients were women. Every lesion that underwent treatment was located on the head and neck.
Clinicians performed dermoscopy, HFUS and RCM before intervention and then at 6 weeks, 3 months and 12 months after RT.
Results showed that BCC-specific features were observed at baseline in 81.8% of patients who underwent imaging with dermoscopy, 91% of those imaged with RCM and 17% of those imaged with HFUS.
Post-treatment resolution of these features was observed in 33.4% of patients in the dermoscopy group, 91.7% of those in the RCM group and 100% of those in the HFUS group.
The researchers reported no recurrences during a mean follow-up duration of 31.7 months. They acknowledged that the small sample size and lack of histopathologic correlation may limit the conclusions drawn from the findings.
“Dermoscopy and HFUS were not as reliable as RCM at characterizing BCC RT response,” the researchers wrote. “RCM could prove to be a valuable tool in the noninvasive evaluation of patients with BCC treated with RT; we were able to successfully observe the tissue response to RT in vivo.”