Revisiting Radiotherapy for Hidradenitis Suppurativa: Clinical Outcomes, Safety, and Optimization Strategies: A Systematic Review.

Objectives

Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease that significantly impairs patients' quality of life, especially in its moderate to severe forms. Traditional treatments, including antibiotics, hormonal therapies, and surgery, often fail to provide long-term relief in such cases. This study aims to explore the role of radiotherapy, particularly with the use of 3D printing technology to create personalized boluses and applicators, as an adjunctive treatment for refractory HS. A systematic review of published studies was conducted to assess the efficacy of radiotherapy in managing HS, with a specific focus on studies using 3D printing technology to create customized boluses and applicators.

Methods

Publications from databases such as PubMed, Scopus, and Google Scholar were analyzed for studies detailing radiotherapy techniques, dosing regimens, and the use of 3D-printed devices in HS treatment. The studies selected included those employing both external beam radiotherapy and brachytherapy, with particular emphasis on patient outcomes and adverse effects.

Results

The reviewed studies highlighted a growing body of evidence supporting the use of radiotherapy for HS, especially in severe or treatment-resistant cases. The use of 3D-printed boluses and applicators in radiotherapy demonstrated significant improvements in treatment precision and patient comfort. Personalized treatment plans allowed for more accurate dose distribution, minimized air gaps, and reduced exposure of healthy tissue. No major long-term toxicity was reported across the majority of studies.

Conclusions

Radiotherapy, particularly when combined with 3D printing technology, presents a promising treatment option for patients with severe or refractory HS. Customizable boluses and applicators enhance the precision of radiotherapy by conforming to irregular skin surfaces, thereby improving dose conformity and reducing side effects. Despite the positive results, further research is needed to assess the long-term safety and clinical feasibility of this approach. The integration of 3D printing in radiotherapy could significantly improve treatment outcomes, offering a more personalized and effective therapeutic option for HS patients.