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Objectives: • Background superficial radiotherapy
• Superficial radiotherapy for non-melanoma skin cancer
• Superficial radiotherapy for benign inflammatory skin diseases
• Side effects of superficial radiotherapy

Introduction: Superficial radiotherapy has been used for over a century for treatment of skin cancers and inflammatory benign skin diseases. The advantage of radiotherapy of skin tumors compared to surgery is that normal adjacent tissue is preserved and the cosmesis is usually good and functional result excellent. Radiotherapy only produces low skin morbidity, is not painful and requires no anesthesia.

Materials / method: Patients suitable for superficial radiotherapy of non-melanoma skin cancer is often patients who are not good candidates for surgery, due to age, comorbidities and personal preferences. However, in tumors with poorly defined margins, location on lower leg or in young patients radiotherapy are not the treatment of choice.
Efficacy and morbidity of superficial radiotherapy depends on dose of radiation, time of dose delivery and fractionation of dose. Another consideration before radiotherapy is the choice of penetration depth of the beam needed which depends of the depth of the tumor.

Results: We routinely treat basal cell carcinomas, squamous cell carcinomas, Kaposis sarcoma and tumor stage cutaneous t-cell lymphomas with high efficacies and good cosmetic results. In an experimental setup very low dose radiotherapy of treatment refractory Hailey-Hailey and Dariers disease has resulted in complete disease control.
Erythema, crusting and slowly wound heling (regression of tumor) is seen up to few weeks after treatment. Late reactions are fibrosis, atrophy, telangiectasias and hyperpigmentation/hypopigmentation and therefore cosmesis may decrease over timer.

Conclusion: Superficial radiotherapy of skin cancer is an effective treatment. It is easy to use for the clinic with minimum patient discomfort and acceptable cosmetic outcome. It is especially suitable for elderly patients refusing surgery or having contraindications for surgery.

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Objectives: This study was designed to evaluate the histologic and immunologic response of a novel technology, nanopulse stimulation for the treatment of nodular Basal Cell Carcinoma

Introduction: Nano-Pulse Stimulation (NPS) technology is a non-thermal treatment modality that delivers nano-second range electrical energy pulses to targeted tissue. NPS pulses act directly on cells within the NPS treatment zone and cause irreversible apoptosis. Pre-clinical models of in situ NPS treated malignant tumors, in a murine model, demonstrated direct elimination of tumor cells, that subsequently trigger release of tumor antigens which stimulate a lasting in situ anti-tumor immune T-cell response. The surrounding non-cellular dermis remains undamaged.

Materials / method: In this multi-center study, adult subjects with non-facial nodular BCC lesions with a minimum lesion size of 5x8 mm, were enrolled. Prior to planned lesion excision, ~50% of the nBCC surface area was treated with a single NPS session. NPS setting was randomized to one of 3 energy levels (3.9J, 7.7J and 15.5J), using a 5x5mm tip. The time between the NPS exposure and lesion excision ranged from 21 to 47 days, with an average of 27 days. Bulk lesion was excised to evaluate presence/absence of residual BCC in known treatment zone and characterize the inflammatory infiltrate.

Results: Pre- and post-treatment biopsies from subset of seven biopsy-confirmed nBCCs were evaluated histologically. As previously reported, 100% (n=7) of histology samples of the NPS treated zone of bulk cut lesions were rated devoid/absence of residual BCC across all energy settings. Of note, CD8+ T-cell  inflammatory infiltrate was detected in some histologic samples of the untreated nBCC tissue. Clinical assessment of pre- and post-treatment photographs and histology indicate that the 5 lesions treated with the two lowest settings (3.9J and 7.7J) demonstrated rapid healing with favorable cosmetic results

Conclusion: NPS technology has promising potential for the treatment of the nodular BCC-subtype based on the complete absence of nBCCs within the NPS treatment zone. Assessment of clinical photographs and histology suggests favorable cosmetic outcomes and a reduced potential for scar formation at the lower energy settings, a major benefit compared to surgical excision of these deep nodular lesions which typically result in a permanent, obvious scar. NPS studies with a larger population are needed to validate these positive findings.

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请注明名称（个人，公司，学会等等）: Pulse Biosciences

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请注明名称（个人，公司，学会等等）: Research Funding for study costs, Consulting fees

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这项工作的完成感谢以下机构的支持： Pulse Biosciences