Table 4.
Recurrence and deaths after external radiotherapy
| Study and No of patients | Site* | Radiotherapy dose | Follow-up | Proportion with outcome (95%CI) | Prognostic features* | |||
|---|---|---|---|---|---|---|---|---|
| Local recurrence | Regional recurrence | Unspecified recurrence | Patient died of disease | |||||
| Abbatucci 1989 (n=179) | Face | Superficial, 0.5-1 cm peripheral margin, 1 mm deep margin. Most doses 30.6 Gy, 3 fractions, 14 days | Minimum 2 years | 0.03 (0.01 to 0.06) | — | — | — | Diameter <1.6 cm to ≥4 cm |
| Barysch 2012 (n=177) | All (head and neck 87%) | Superficial, beryllium windowed, soft x rays | Mean 4.9 years (SD 4.7, 95% CI 4.2 to 5.6) | 0.14 (0.10 to 0.20) | 0.01 (0.00 to 0.03) | — | — | Mean area 3.5 cm2; differentiation: good (66.7%), moderate (22.4%), poor (10.9%) |
| Grosch 1979 (n=5) | Head and hand | 6-10 meV electron beam, total dose 4000-6000 rads, 10-20 fractions, 14-28 days | Mean 15 months (range 6-33) | — | — | 0.00 (0.00 to 0.52) | — | No data |
| Holmes 1982 (n=67) | Various | Short distance cobalt unit, 5000-5500 cGy, 10-15 fractions, 2-3 weeks | 2-8 years | — | — | 0.00 (0.00 to 0.05) | 0.00 (0.00 to 0.05) | No data |
| Honeycutt 1973 (n=18) | Various | X rays, total dose 4500 rads, 9 or 15 fractions | 4 years (range 4-8) | — | — | 0.00 (0.00 to 0.18) | — | Diameter <2 cm (39%), >2 cm (61%) |
| Hunter 1982 (n=26) | Pinna | 10 meV electron beam, total dose 4500-5500 cGy, 8-15 daily fractions | Average 44 months (range 12-136) | — | — | 0.11 (0.02 to 0.30) | 0.08 (0.01 to 0.25) | Mean duration 26 months (range 1-186) |
| Knox 1987 (n=101) | All | Total dose 4000-5000 rads, 500 or 1000 rads every other day, ≤10 fractions | >1 year | — | — | 0.02 (0.00 to 0.07) | — | Diameter <2 cm (79%), >2 cm (21%) |
| Kwan 2004 (n=37) | Various | Orthovolt x rays, electrons, megavoltage photons, or combination of electrons and photons; Total dose <4000 cGy to >6000 cGy, 5-25 fractions | Median 42 months (range 1.4-97.1) | 0.30 (0.16 to 0.47) (“locoregional recurrence”) |
— | — | — | Tumour stages T2 (19%), T3 (65%), T4 (16%) |
| Matthiesen 2011 (n=3) | Cheek and forehead | 3D conformal radiotherapy with 6 mV photons or intensity modulated radiotherapy with 6 mV photons; total dose 7425-7980 cGy, 33-35 fractions | Mean 14.3 months (range 4-36) | — | — | 0.67 (0.09 to 0.99) | 0.67 (0.09 to 0.99) | All tumour stage 4; volumes 126 cm3, 175 cm3, 341 cm3; bone involvement in 1 tumour |
| Podd 1992 (n=17) | Lower leg | Photon based; dose not specified | Not specified | 0.06 (0.00 to 0.29) | — | — | — | No data |
| Rank 1973 (n=231) | Not specified | No details | 2 years | 0.03 (0.01 to 0.06) | — | — | — | No data |
| Shiffman 1975 (n=2) | Pinna | No details | <1 year to >3 years | 0.5 (0.01 to 0.99) | 0.5 (0.01 to 0.99) | — | 0.5 (0.01 to 0.99) | 1 SCC 2-4 cm (no data for second SCC) |
| Stoll 1964 (n=62) | Nose | Roentgen therapy 4000-8000 rads in 300-500 rads fractions over ≤26 days | <6 months to 144 months | 0.03 (0.00 to 0.11) | — | — | — | Diameter <0.5 cm (33.9%), 0.5-1 cm (56.4%), 1.5-2.5 cm (4.8%), >2.5 cm (4.8%) |
| Tsao 2002 (n=93) | Nose | Orthovoltage (81%); electrons (14%), megavoltage x rays (4%); high energy photons (1%) | Median 2.9 years (0.2–10.4) | 0.06 (0.02 to 0.14) | 0.02 (0.00 to 0.08) | — | 0.03 (0.01 to 0.09) | Tumour stages T1 (64%), T2 (11.7%), T3 (0%), T4 (7.4%); stage not evaluable (17%); 5 immunosuppressed patients |
SD=standard deviation; 3D=three dimensional.
*Percentages indicate proportion of patients in study.