Background: Non-melanoma skin cancers (NMSCs) are the most common cancers in the United States. Image-guided superficial radiation therapy (IGSRT) is an effective treatment for NMSCs. Patient comorbidities and socioeconomic status (SES) are known contributors to health disparities. However, the impact of comorbidities or SES on the outcomes of IGSRT-treated NMSCs has not yet been studied. This study evaluated freedom from recurrence in IGSRT-treated NMSCs stratified by SES and the number of comorbidities. Methods: This large retrospective cohort study evaluated associations between SES (via Area Deprivation Index (ADI)) or comorbidity (via Charlson Comorbidity Index (CCI)) and 2-, 4-, and 6-year year freedom from recurrence in patients with IGSRT-treated NMSC (n= 19,988 lesions). Results: Freedom from recurrence in less (ADI ≤ 50) vs. more (ADI > 50) deprived neighborhoods was 99.47% vs. 99.61% at 6 years, respectively (p= 0.2). Freedom from recurrence in patients with a CCI of 0 (low comorbidity burden) vs. a CCI of ≥7 (high comorbidity burden) was 99.67% vs. 99.27% at 6 years, respectively (p= 0.9). Conclusions: This study demonstrates that there are no significant effects of SES or comorbidity burden on freedom from recurrence in patients with IGSRT-treated NMSC. This supports the expansion of IGSRT in deprived neighborhoods to increase access to care, and IGSRT should be a consideration even in patients with a complex comorbidity status.
背景：非黑色素瘤皮肤癌是美国最常见的癌症类型。图像引导浅层放射疗法是治疗非黑色素瘤皮肤癌的有效手段。患者合并症与社会经济状况是导致健康差异的已知因素，但二者对接受图像引导浅层放射疗法治疗的非黑色素瘤皮肤癌患者预后的影响尚未明确。本研究通过社会经济状况与合并症数量分层，评估接受图像引导浅层放射疗法治疗的非黑色素瘤皮肤癌患者的无复发生存情况。 方法：这项大型回顾性队列研究通过区域剥夺指数评估社会经济状况，通过查尔森合并症指数评估合并症情况，分析二者与接受图像引导浅层放射疗法治疗的非黑色素瘤皮肤癌患者（共19,988处病灶）2年、4年及6年无复发生存率的相关性。 结果：在区域剥夺指数≤50（资源较优社区）与>50（资源匮乏社区）的患者中，6年无复发生存率分别为99.47%与99.61%（p=0.2）。查尔森合并症指数为0（低合并症负担）与≥7（高合并症负担）的患者6年无复发生存率分别为99.67%与99.27%（p=0.9）。 结论：本研究表明社会经济状况与合并症负担对接受图像引导浅层放射疗法治疗的非黑色素瘤皮肤癌患者无复发生存率无显著影响。这支持在资源匮乏社区推广图像引导浅层放射疗法以提升医疗可及性，且对于存在复杂合并症状态的患者也应考虑采用该治疗方案。
肿瘤(癌症)患者之家