Patient-Orientated Evaluation of Treatment of Non-Melanoma Skin Cancer with Rhenium-188 Compared to Surgery

Maila I C Krönert; Sarah M Schwarzenböck; Jens Kurth; Martin Heuschkel; Bernd J Krause; Steffen Emmert; Julia K Tietze

doi:10.3390/healthcare12090921

Patient-Orientated Evaluation of Treatment of Non-Melanoma Skin Cancer with Rhenium-188 Compared to Surgery

Healthcare (Basel). 2024 Apr 29;12(9):921. doi: 10.3390/healthcare12090921.

Authors

Maila I C Krönert¹, Sarah M Schwarzenböck², Jens Kurth², Martin Heuschkel², Bernd J Krause², Steffen Emmert¹, Julia K Tietze¹

Affiliations

¹ Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany.
² Department of Nuclear Medicine, University Medical Center Rostock, 18057 Rostock, Germany.

Abstract

Background: Non-melanoma skin cancers (NMSCs) are responsible for up to one-third of all human malignancies. Surgery is usually the treatment of choice, but patients often experience pain during the procedure. Topical rhenium-188 resin skin cancer treatment (RSCT) may be a valid therapeutic alternative.

Methods: In this monocentric pilot study, 19 patients suffering from NMSC were treated with RSCT. Most of these patients had also experienced surgery, either because they developed a new NMSC in aftercare, or they had suffered previously from NMSC. Three RSCT-treated patients, who had no exposure to surgery so far, were paired with three matched patients, who had received surgery. We sought to evaluate and compare the patients' experience with both treatments. A questionnaire assessed patients' perceptions regarding side effects, aesthetic outcomes, wound care, fear of complications, and personal treatment preferences. Patients evaluated the different parameters of their either RSCT- or surgery-treated lesions on a scale from 0-10.

Results: Patients were more afraid of complications before surgery than before RSCT (p = 0.04). Treatment with RSCT caused significantly less pain on treatment day (mean 0.56) than surgery (mean 2.32) (0 no pain, 10 maximum pain) (p = 0.02) and 14 days after the procedure (mean 0.89 versus mean 2.47) (p = 0.02). On day 14, RSCT-treated lesions were also significantly less itchy (mean 0.34) than after surgery (mean 1.50). Most patients were very satisfied with the aesthetic outcome after both RSCT (mean 8.42) and surgery (mean 8.31) (p = 0.89). In the case of a new NMSC, the majority of patients who experienced both treatments would rather be treated primarily with RSCT (44%) or would consider both options (31%); only 19% preferred surgery.

Conclusion: Patients evaluated RSCT as less painful than surgery. The aesthetic outcomes of both treatments were comparable. For pain-sensitive patients, RSCT might be a preferable treatment option.

Keywords: non-melanoma skin cancer; rhenium-188; surgery; treatment.

Grants and funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. SE is supported by the German Research Foundation (DFG, EM 68/13–1 and EM 68/15-1), the German Federal Ministry of Education and Research (BMBF, 16GW0345), the Ministry of Commerce, Occupation, and Health of Mecklenburg—West Pomerania, Germany (TBI-V-1–349-VBW-120), the European Fond for Regional Development (GSH-20–0054), and by the Ministry for Commerce and Energy Germany (03TN0019B).