Safety and Effectiveness of Superficial Radiation Therapy in the Treatment of Skin Diseases: A Systematic Review

Abstract

Context: Superficial radiation therapy is a low energy radiation therapy that is penetrated only within a short distance under the skin surface, and widely used by dermatologists. This study aimed at investigating the safety and effectiveness of superficial radiation therapy versus other conventional treatments in the treatment of skin diseases.
Methods: The following databases were searched systematically from March 31st, 2017: PubMed, and the Cochrane Library. MeSH terms and free-text were used for searching the databases. Additional studies were retrieved from a manual search and reference lists of included studies. Only studies written in English were considered and there was no time limit in the inclusion criteria. The quality of included studies was assessed using the Oxford centre for evidence-based Medicine (OCEBM) levels of evidence criteria.
Results: In total, 12 studies were included in this review. In total, 1985 patients were examined. Most of the eligible studies (11 out of 12 with 1795 patients) compared the effectiveness outcomes (efficacy, improvement rate, failure rate, clinical improvement, time of use, recurrence rate, and cosmetic consequences). About half of them (5 out of 12 with 530 patients) compared the safety outcomes (side effects and the severity of symptoms).
Conclusions: Based on the available evidence, which was not up to date and generalizable, it could be concluded that superficial radiation therapy had no side effect on the treatment of hand eczema and also had better treatment results and could be used for hand eczema, yet for other indications, further studies need to be performed. The use this technology along with other methods may have better consequences for the patients. In order to make better decisions in this area, new studies must be carried out in various contexts. However, if superficial radiation therapy is licensed to be used in a country, in order to prevent low but serious side effects, there must be a coherent system with the aim of recording its use for each patient.