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A device for performing in-office electron radiation therapy (DermaBeam with Mobetron, IntraOp Medical) allows dermatologists to offer an entire gamut of skin cancer treatment modalities, and better meet the varying needs of individual patients.
National report - A device for performing in-office electron radiation therapy (DermaBeam with Mobetron, IntraOp Medical) allows dermatologists to offer an entire gamut of skin cancer treatment modalities, and better meet the varying needs of individual patients.
Back into the mainstream
"Historically, radiation therapy had an important place in the treatment of skin cancers, and a number of studies document its efficacy as primary intervention and for increasing cure rates when used as an adjunct to surgery for treating high-risk cancers," Dr. Jaffe says. "Moreover, because radiation therapy is noninvasive, it can offer a number of advantages over surgery, both in terms of improved cosmetic outcomes and avoiding issues of postoperative infection, woundcare and healing-related problems.
"For the latter reasons, radiation therapy may be a preferred option whenever difficulty in achieving closure or with healing is a concern, such as in older, infirm or diabetic patients or for treating large tumors requiring extensive reconstruction," Dr. Jaffe says. "Importantly, radiation is part of the NCCN (National Comprehensive Care Network) guidelines as a primary form of skin cancer treatment. It is also a nice alternative to offer patients who, for some personal reason, may be fearful of surgery. However, radiation therapy is often overlooked as an option by dermatologists who do not offer this modality in their office."
"Radiation therapy is a very effective treatment for many skin cancers and can be a very valuable alternative to surgery in certain situations," Dr. Cockerell says. "Because radiation therapy requires multiple treatments and there were some drawbacks of older technology, its use fell into disfavor with the advent of dermatologic surgery and Mohs micrographic surgery.
"This new mobile EBRT platform promises to reintroduce radiation therapy as an option for skin cancer to the dermatologist. It represents new technology that is an improvement over radiation therapy of the past," he says.
Dr. DeNittis notes that the DermaBeam treatment enables a multidisciplinary approach to care for skin cancer treatment. This model is followed for many other cancers, but is notably absent in the management of skin cancer, he says.
"The downfall of not having a multidisciplinary approach is that the patient receives disjointed, fragmented care. With the availability of this in-office radiation therapy platform, patients benefit from a treatment scheme that is based on the input of the dermatologist and the radiation oncologist.
"Moreover, the treatment is administered in a setting that is more convenient and more comfortable compared with a dedicated radiation oncology facility, where the patient with skin cancer encounters many dying and debilitated cancer patients suffering from advanced disease," Dr. DeNittis says.