
Mission of the Research Council
To share and advocate for research on skin cancer therapies

Dr. Lio Yu
Research Chair
Current Activities
Relating to dermatologic use of Radiation Therapy:
- Safety and Quality Assurance
- Effectiveness and cost of comparative modalities
- Access to skin ca RT technology
- Evaluation of alternative and emerging treatment modalities
- Toxicity management
- Awareness and Adoption of RT for dermatologic conditions
- Sanctioning and funding of DART research aims/priorities
Studies Supporting the Use of Radiation Therapy to Treat Skin Cancer
2025
Zakria D, et al. SKIN. 2025;9(1):2042-2054. doi:10.25251/skin.9.1.1.
The DART-funded project conducted a comprehensive literature review using PubMed, EMBASE, Scopus, and Google Scholar, focusing on the role of Image-Guided Superficial Radiotherapy (IGSRT) in the treatment of nonmelanoma skin cancer (NMSC). A panel of six board-certified dermatologists, all experts in managing NMSC, reviewed the literature and developed ten consensus statements based on the findings.
Among these statements, the panel reached a consensus that “IGSRT is a safe and effective treatment for NMSC, often yielding highly favorable cosmetic outcomes. It may be considered a first-line treatment option for appropriately selected cases of NMSC.”
The findings and recommendations of this panel were published in the January 2025 issue of SKIN: The Journal of Cutaneous Medicine, a peer-reviewed publication.
2024
Ma L, et al. Cancers. 2024;16(4037). doi:10.3390/cancers16234037
This retrospective cohort study evaluated the impact of socioeconomic status (SES) and comorbidities on freedom from recurrence in 19,988 non-melanoma skin cancer (NMSC) lesions treated with image-guided superficial radiation therapy (IGSRT). The study stratified patients by neighborhood deprivation and comorbidity burden to assess their influence on 2-, 4-, and 6-year recurrence rates.
Freedom from recurrence rates were consistently high across all groups, with no significant differences observed based on SES or comorbidity burden. These findings support the use of IGSRT as an effective treatment for NMSC, regardless of socioeconomic status or comorbidity burden.
McClure E, et al. Adv Radiat Oncol. 2024. doi:10.1016/j.adro.2024.101463
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 histology (0.7% vs 5.8%, respectively; p<.001)
Agha R, et al. J Clin Med. 2024;13(5835). doi:10.3390/jcm13195835
Large, retrospective cohort study to determine the effect of risk factors (tumor location, tumor stage, and patient sex) on 2-, 4-, and 6-year freedom from recurrence rates in 19,988 NMSC lesions treated with image-guided superficial radiation therapy (IGSRT), including lesions with complete treatment courses.
Overall freedom from recurrence rates for lesions treated with IGSRT were 99.68% at 2 years, 99.54% at 4 years, and 99.54% at 6 years. Rates did not differ significantly by tumor location (head/neck versus other locations, p=0.9) or sex (male versus female, p=0.4). Although significant differences were seen by tumor stage (p=0.004), freedom from recurrence rates exceeded 99% for patients with tumors of all stages.
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.
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.
2023
McClure E, et al. Clin Transl Radiat Oncol. 2023;43:1-5. doi.org/10.1016/j.ctro.2023.100678
A retrospective cohort study comparing the 2-year recurrence probability of 2286 early stage BCCs and SCCs treated with IGSRT 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 IGSRT 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)
Yu L, et al. BMC Cancer. 2023;23(1):98. doi:10.1186/s12885-023-10577-z
Logistic regression analysis comparing LC 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).
LC 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.
Tran A, et al. J Cancer Res Clin Oncol. 2023;149:6283-2691. doi:10.1007/s00432-023-04597-2
Retrospective chart review evaluating LC 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 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 an RTOG score of 1 or 2.
2022
Yu L, et al. Discov Onc. 2022;13:129. doi:10.1007/s12672-022-00593-z
Meta-analysis comparing LC 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.
LC 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.
2021
Yu L, et al. Oncol Ther. 2021;9(1):153-166. doi:10.1007/s40487-021-00138-4
Retrospective chart review evaluating LC rates of 1632 patients with 2917 stage 0-II carcinomas.
99.3% LC rates with an industry-proven, 20-faction protocol—IG-SRT is safe and tolerable and should be considered a first-line option for NMSC.
2017
Patel R, et al. J Contemp Brachytherapy. 2017;9(4):338–344. doi:10.5114/jcb.2017.68480
Matched-pair cohort study comparing the outcomes of treatment with electronic brachytherapy (EBT) to those of Mohs micrographic surgery (MMS) in patients with NMSC. Patients from 4 treatment centers who were treated with EBT (208 lesions) were case matched to those treated with MMS (208 lesions) based on retrospectively collected patient age, lesion size, location and type, and year of treatment. Prospective follow-up data was collected to access differences in local recurrence, toxicities, cosmesis, and patient reported outcomes.
At mean 3.4 years post-treatment, 99.5% of EBT and 100.0% of MMS-treated lesions were free of recurrence. One recurrence was noted in the EBT group. Physicians rated cosmesis as “excellent” or “good” in 97.6% of EBT-treated lesions, and 95.7% of MMS-treated lesions.