If you have been diagnosed with non-melanoma skin cancer, learn more about a gentler way to treat skin cancer.

Published Research on the Use of Image-Guided Superficial Radiation Therapy (IG-SRT) in the Treatment of Nonmelanoma Skin Cancer (NMSC)

See the growing clinical evidence supporting the use of Image-Guided Superficial Radiation Therapy (Image-Guided SRT) as a first-line treatment option for patients with NMSC.



Farber AS, et al. Geriatrics. 2024;9(5):114-127. doi:10.3390/geriatrics9050114

Retrospective cohort study to determine the freedom from recurrence rates at year 2, 4, and 6 post-treatment in patients ≥65 years (16,911 lesions) vs <65 years (3158 lesions) with nonmelanoma skin cancers (NMSC) treated with guideline-directed image-guided superficial radiation therapy (IGSRT).

IGSRT demonstrated a freedom from recurrence rate >99.5% at 2, 4, and 6 years post-treatment, regardless of age or gender. Patients ≥65 years did demonstrate a difference in freedom from recurrence rates when stratified by stage at 2, 4, and 6 years, with slightly poorer outcomes seen in patients with stage 2 NMSC.

These findings demonstrate that IGSRT is a viable therapeutic option for patients with NMSC regardless of patient age, sex, or stage, and bolster previous findings that IGSRT demonstrates excellent local tumor control and absolute lesion control and superior recurrence rates in this cohort relative to traditional SRT and historical rates of MMS.



Stricker JB, et al. Dermato. 2024;4:86-96. doi:10.3390/dermato4030010

Retrospective chart review of 883 patients with 1507 NMSC treated at 7 dermatology practices with IG-SRT showed 92% of NMSC lesions had daily depth fluctuations, with nearly 40% of lesions requiring at least one change during treatment.

Full dermal visualizations via high-resolution dermal ultrasound imaging informs providers of when adaptive changes in energy (kV), time dose fractionation, and dose are needed to optimize efficacy and minimize toxicity.

Full dermal visualization of the constantly changing NMSC tumor depth throughout therapy allows the dermatologist and radiation therapist to make compensatory adjustments in real time…the first time in history that dermatologists and radiation therapists have been able to visualize the reactive changes that BCC and SCC undergo during radiation therapy.

McClure E, et al. Adv Radiat Oncol. 2024.

Retrospective cohort study evaluating the 2-year freedom from recurrence rate of 2880 NMSCs (BCC, SCC, and SCCIS) treated with IGSRT, and comparing it to recurrence rates in pooled data from 2 studies in which 5615 NMSCs were treated with non-image-guided SRT

IGSRT-treated lesions had a 99.2% 2-year freedom from recurrence rate, which was shown to be a significantly improved outcome compared with SRT-treated lesions across histologies (0.7% vs 5.8%, respectively; p<.001)

IGSRT offers statistically significantly improved outcomes compared to standard SRT, and a more desirable toxicity profile to surgical options…IGSRT is associated with remarkably low recurrence rates…in line with modern outcomes for Mohs micrographic surgery.

McClure E, et al. Clin Transl Radiat Oncol. 2023;43:1-5

A retrospective cohort study comparing the 2-year recurrence probability of 2286 early stage BCCs and SCCs treated with IG-SRT to 5391 early stage BCCs and SCCs treated with Mohs micrographic surgery (MMS)

Results showed significantly lower 2-year skin cancer recurrence in patients treated with Image-Guided SRT compared to those treated with Mohs surgery, in both pooled NMSC lesions (P<.001) and when stratified by cancer type: BCC (P=.022) and SCC (P<.001)

There is a statistically significant improvement in 2-year recurrence probabilities of NMSCs when treated primarily with IG-SRT compared to MMS. This suggests that IG-SRT should become a first-line recommendation for patients with early stage NMSCs like BCCs, and SCCs…

Tran A, et al. J Cancer Res Clin Oncol. 2023.

Retrospective chart review evaluating local control rates of 1243 patients with 1899 stage 0-II NMSC (BCC, SCC, and SCCIS) who received treatment with IG-SRT energies ranging from 50 to 100 kV, for a mean of 20.2 fractions, and treatment dose of 5364.4 cGy

99.7% of patients achieved absolute lesion local control after an average of 7.5 weeks of treatment, 99.6% of patients achieved stable control with >12 months follow-up, and 95% of lesions had a RTOG score of 1 or 2

IG-SRT has a high safety profile, can achieve superior cosmesis and should be considered first-line for treating early-stage NMSC tumors as cure rates have been shown to be effective in all NMSC on early follow-up…making it a safe, and potentially cost-effective option for NMSC treatment compared to surgery.

Yu L, et all. BMC Cancer. 2023;23(1):98.

Logistic regression analysis comparing local control rates found in 4 studies using non–image-guided radiotherapy to LC rates of a study that used US-SRT, with stratification by histology (BCC, SCC, and SCCIS)

Local control rates with US-SRT were statistically superior to those found in studies using non–image-guided radiation therapy, individually and comparatively and across histological subtypes, with P-values ranging from P<.0001 to P=.0438

Image guidance with high resolution dermal ultrasound in the form of US-SRT is shown to confer a statistically significant advantage in lesion local control over non–image-guided forms of SRT or XRT in all subtypes of cutaneous epithelial NMSC and should be considered the preferred standard of non-surgical treatment for early-stage cutaneous BCC, SCC, and SCCIS.

Tran A, Yu L. J Dermaol Skin Sci. 2022;4(4):6-8.

Review of the evidence supporting the potential for IG-SRT to improve access to skin cancer treatment in poor and rural communities

  • Skin cancer is the most common cancer in the United States, with incidence rates of melanoma and NMSC on the rise
  • Reduced access to cancer treatment and long travel times may contribute to poor outcomes for patients in non-metropolitan counties

  • Collaboration across care providers can address disparities in access to oncodermatologic care (dermatologists, surgeons, otolaryngologists, radiation oncologists, and radiation therapists)
  • With favorable clinical and cosmetic outcomes, tolerable side effects, and flexibility in treatment administration locations, IG-SRT may help improve access to skin cancer treatment in poor and rural communities
The use of modern superficial radiation therapy might address disparities in dermatologic care.

Yu L, et al. Discov Oncol. 2022;13(1):129.

Meta-analysis comparing local control rates of 2 seminal studies that used high-resolution dermal ultrasound-guided SRT (US-SRT) with 4 studies that used traditional non–image-guided radiotherapy (XRT and SRT) in the treatment of NMSC

Local control rates for the 2 US-SRT studies were statistically superior to the 4 traditional therapies individually and collectively. When stratified by histology, statistically superior outcomes for US-SRT were observed in all subtypes

US-SRT is statistically superior to non–image-guided radiotherapies for NMSC treatment. This modality may represent the future standard of non-surgical treatment for early-stage NMSC.

Yu L, et al. Oncol Ther. 2021;9(1):153-166.

Retrospective chart review evaluating LC rates of 1632 patients with 2917 stage 0-II carcinomas

99.3% local control rates with an industry-proven, 20-fraction protocol—IG-SRT is safe and tolerable and should be considered a first-line option for NMSC

Cure rates observed in this initial period of follow-up are similar, and potentially superior with further follow-up, to traditional SRT and surgical options.

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See the Difference In Partnering with SkinCure Oncology

Interested in making Image-Guided SRT a treatment option at your practice? Contact us to discuss all the ways SkinCure Oncology can help.