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Article History

Received: 4 September 2024

Accepted: 5 March 2025

First Online: 22 March 2025

Declarations

:

: Ethics committee/IRB of WCG IRB waived ethical approval for this work. WCG IRBs IRB Affairs Department reviewed the study under the Common Rule and applicable guidance. The response state this study is exempt under 45 CFR| 46.104(d) [], because the research involves the use of identifiable private information; and information is recorded by the investigator in such a manner that the identity of the human subjects cannot readily by ascertained directly or through identifiers linked to the subjects, the investigator does not contact the subjects, and the investigator will not re-identify subjects. Informed consent was received from all patients prior to treatment.

: Not applicable.

: Mairead Moloney has no conflicts of interest to disclose. Peter Kaczmarksi has no conflicts of interest to disclose. Songzhu Zheng has no conflicts of interest to disclose. Ariana Malik has no conflicts of interest to disclose. Dr. Daniel Ladd is the Chief Medical Officer for Skin Cure Oncology and has received research, speaking and/or consulting support from Skin Cure Oncology. Dr. Ladd is also the Medical Director and Founder of Tru-Skin Dermatology. Dr. Donna Serure has no conflicts of interest to disclose. Peyton Harris has no conflicts of interest to disclose. Dr. Lio Yu is the National Radiation Oncologist for Skin Cure Oncology and has received research, speaking and/or consulting support from Skin Cure Oncology. He has served on an advisory board for Bayer Pharmaceuticals previously.

: A The IGSRT treatment protocol has evolved over the past 5–6 years, specifying time dose fractionation (TDF) number/dose/fractionation based on ultrasound depth and tumor type. This protocol recommends a fractionation dose range of 245–279 cGy for 20 fractions 3–4 times a week to achieve a therapeutic biological dose range of 90–99 or greater TDF number using 50, 70, or 100 kV energy. Higher doses per fraction and/or more fractions were recommended for larger, deeper, and high-risk lesions [].B If follow-up date was unavailable, treatment completion date was used as the last follow-up date. If treatment completion date was unavailable, treatment start date was used as the treatment completion date and last-follow-up date. Days were converted to months using the approximation of 30.417 days per month and days were converted to weeks using 7 days per week.