Comprehensive Answers to Your IG-SRT Treatment Questions

Welcome to our FAQ page for IG-SRT treatment. Here, you’ll find clear answers to common questions about the procedure, benefits, and considerations to help you feel informed and confident in your treatment journey.

It is best practice to deliver the first treatment within 24 hours post shave or excision. Ideally, the remaining two fractions would be delivered the next two consecutive days. If 3 consecutive treatments are not able to be performed, it is acceptable to have 1-2 days break.

Any time a site has already been treated with radiation the medical records should be obtained and reviewed. Most of the time, keloids can be treated a second round at 400cGy/fx for 3 fractions.

Alternative options for the treatment of keloids include intralesional corticosteroid injections, excision, silicone gel sheeting, cryosurgery, pressure earrings, interferon alpha, laser therapy and fluorouracil injections. In general, it is widely accepted that post-excision radiation therapy works best, but the patient should be made aware of all options available.

Patients can be treated 3 days in a row during the course of care, but it is not recommended for entire course of care. Ideally, fractions will have a day in between, example: M-Tu-Th.

In general, it is recommended to NOT treat patients under the age of 18 for keloids or NMSC. Young adults can be treated with IG-SRT, but a thorough consultation should be performed and documented explaining the risk(s) of secondary lesions developing in the treatment area(s). Other options for the treatment of keloids include injected intralesional corticosteroids, excision (and observe, 90% chance of reoccurrence), silicone gel sheeting, cryosurgery, pressure earrings, interferon alpha, laser therapy, and injection of fluorouracil.

In some cases, yes. If a patient is currently undergoing chemotherapy, the radiation therapist should seek out the medication(s)/ chemo agent(s) the patient is taking and have this information reviewed with SCO Round Table prior to treatment.

Antioxidants can reduce efficacy of treatments, therefore, should be avoided while a patient is undergoing IG-SRT. The use of antioxidants can be resumed immediately after the last fraction of IG-SRT. Other medications can be radiosensitizers. It is best practice to consult with SCO Round Table if there are any questions and/or concerns about medications.

Yes, IG-SRT is an acceptable form of treatment for recurrences over existing surgical sites but NOT for previously irradiated sites.

Yes, however, it is best to review the patients’ medication history for potential contraindications. Furthermore, these patients should be monitored closely for slower healing at treatment site(s).
differentiated or sclerosing) or skin cancers that are larger than 10mm in diameter a 10mm margin should be drawn around the clinical tumor. Also, any scars at the edge of a clinical tumor should be considered to be an extension of that tumor. Scar tissue adjacent to BCC or SCC lesions often conceals more BCC or SCC below the scar.

It is highly recommended that only those patients which have positive pathology are treated with IG-SRT, or those which the provider has clinically verified and documented evidence of disease.

Yes, if possible, please attempt to remove any scabs prior to IG-SRT. This can be done with a warm, wet compress or softening with frequent use of Aquaphor. It is highly recommended to NOT use peroxide, alcohol, or related products.

Common contraindications include melanoma, active lupus or scleroderma, previous irradiation to the same location, perineural involvement and tumors not freely moveable because they are “bound down” to deeper structures. Lesions within 1” of a pacemaker require lead shield to cover pacemaker. Other contraindications include:

  • Ehlers Danlos
  • Basal Cell Nevus Syndrome (Gorlin’s)
  • Ataxia Telangiectasia
  • Ataxia-Telangiectasia-like
  • Xeroderma Pigmentosa
  • Ehler’s Danlos Syndrome
  • Nijmegen Breakage Syndrome Relative contraindications to RT:
  • Collagen Vascular Disease

Link regarding collagen vascular disease and RT: https://en.m.wikibooks.org/wiki/Radiation_Oncology/Contraindications

Article showing increased late toxicity with SLE and Sclerderma:
https://www.researchgate.net/publication/227611325_Toxicity_of_radiotherapy_in_patients_with_collagen_vascular_disease

Common medications that are contraindicated with IG-SRT include: Methotrexate, Cisplatin, Carboplatin, Gemcitabine, Venclexta, Forteo, Bendamustine infusions, Acalabrutinib, Accutane, and Avastin (radiation should not be delivered within 2-3 months after the last dose of this drug).

Ideally, patients should not conceive for at least 6 months after IG-SRT in the pelvic area.

Infected areas can be treated with IG-SRT so long as the parameters of the treatment are not compromised, such as an abscess that causes a significant change in SSD.

Typically, hair transplants do not survive in irradiated areas.

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