{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T10:50:36Z","timestamp":1776077436714,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,3,4]],"date-time":"2020-03-04T00:00:00Z","timestamp":1583280000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Epithelial neoplasms of the scalp account for approximately 2% of all skin cancers and for about 10\u201320% of the tumours affecting the head and neck area. Radiotherapy is suggested for localized cutaneous squamous cell carcinomas (<jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content>) without lymph node involvement, multiple or extensive lesions, for patients refusing surgery, for patients with a poor general medical status, as adjuvant for incompletely excised lesions and\/or as a palliative treatment. To date, prognostic risk factors in scalp <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> patients are poorly characterized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify patterns of patients with higher risk of postradiotherapy recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective observational study was performed on scalp <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> patients with histological diagnosis who underwent conventional radiotherapy (50\u2013120\u00a0kV) (between 1996 and 2008, follow\u2010up from 1 to 140 months, median 14\u00a0months). Out of the 79 enrolled patients, 22 (27.8%) had previously undergone a surgery. Two months after radiotherapy, 66 (83.5%) patients achieved a complete remission, 6 (7.6%) a partial remission, whereas 2 (2.5%) proved non\u2010responsive to the treatment and 5 cases were lost to follow\u2010up. Demographical and clinical data were preliminarily analysed with classical descriptive statistics and with principal component analysis. All data were then re\u2010evaluated with a machine learning\u2010based approach using a 4th generation artificial neural networks (<jats:styled-content style=\"fixed-case\">ANN<\/jats:styled-content>s)\u2010based algorithm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Artificial neural networks analysis revealed four scalp <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> profiles among radiotherapy responsive patients, not previously described: namely, (i) stage T2 <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> type, aged 70\u201380\u00a0years; (ii) frontal <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> type, aged &lt;70\u00a0years; (iii) non\u2010recurrent nodular or nodulo\u2010ulcerated, stage T3 <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> type, of the vertex and treated with &gt;60 Grays (Gy); and (iv) flat, occipital, stage T1 <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> type, treated with 50\u201359\u00a0Gy. The model uncovering these four predictive profiles displayed 85.7% sensitivity, 97.6% specificity and 91.7% overall accuracy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patient profiling\/phenotyping with machine learning may be a new, helpful method to stratify patients with scalp <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content>s who may benefit from a <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>\u2010treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.16210","type":"journal-article","created":{"date-parts":[[2020,1,22]],"date-time":"2020-01-22T18:29:08Z","timestamp":1579717748000},"page":"1369-1373","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Artificial neural networks allow response prediction in squamous cell carcinoma of the scalp treated with radiotherapy"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2390-6505","authenticated-orcid":false,"given":"G.","family":"Damiani","sequence":"first","affiliation":[{"name":"Clinical Dermatology IRCCS Istituto Ortopedico Galeazzi Milan Italy"},{"name":"Department of Biomedical, Surgical and Dental Sciences University of Milan Milan Italy"},{"name":"Young Dermatologists Italian Network Centro Studi GISED Bergamo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Grossi","sequence":"additional","affiliation":[{"name":"Fondazione Villa Santa Maria Tavernerio Como Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Berti","sequence":"additional","affiliation":[{"name":"Phototherapy Unit Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico Milan Italy"},{"name":"Dermatology Unit Dipartimento di Fisiopatologia Medico\u2010Chirurgica e dei Trapianti Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico di Milano Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9209-2883","authenticated-orcid":false,"given":"R.R.Z.","family":"Conic","sequence":"additional","affiliation":[{"name":"Department of Dermatology Case Western Reserve University Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"U.","family":"Radhakrishna","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Oakland University William Beaumont School of Medicine Royal Oak MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0348-0620","authenticated-orcid":false,"given":"A.","family":"Pacifico","sequence":"additional","affiliation":[{"name":"Clinical Dermatology Department IRCCS S. Gallicano Dermatological Institute Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.L.","family":"Bragazzi","sequence":"additional","affiliation":[{"name":"School of Public Health Department of Health Sciences (DISSAL) University of Genoa Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Piccinno","sequence":"additional","affiliation":[{"name":"Phototherapy Unit Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico Milan Italy"},{"name":"Dermatology Unit Dipartimento di Fisiopatologia Medico\u2010Chirurgica e dei Trapianti Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico di Milano Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0305-3146","authenticated-orcid":false,"given":"D.","family":"Linder","sequence":"additional","affiliation":[{"name":"Ben Gurion University of the Negev Beer Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,3,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2017.08.059"},{"key":"e_1_2_7_3_1","unstructured":"NCCN Guidelines Version 2.2018.Squamous cell skin cancer MS \u20102\/MS\u201028 and SCC\u20101\/SCC\u20105 and SCC\u2010A\/SCC\u2010D. 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