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Radiotherapy Skin Cancers Head and Neck

[Radiotherapy of basal cell carcinoma of the face and head: Importance of low dose per fraction on long-term outcome].

[Article in German]

Olschewski T1, Bajor K, Lang B, Lang E, Seegenschmiedt MH.

J Dtsch Dermatol Ges. 2006 Feb;4(2):124-30.

BACKGROUND:

Radiotherapy plays an important role in the treatment of basal cell carcinoma of the face and head and achieves cure rates of 92-96 %. Different fractionation concepts of radiotherapy have been described. This study investigates the efficacy, as well as acute and chronic toxicity, of a slightly hypo-fractionated radiotherapy schedule.

PATIENTS AND METHODS:

85 patients with 104 tumors underwent radiotherapy for basal cell carcinoma of the face and head. The radiotherapy schedule was 5 x 3 Gray/week up to a total dose of 57 Gray in 95 % of patients. Acute and late radiotherapy toxicity and cosmetic outcome were evaluated in long-term follow-up.

RESULTS:

No recurrence was observed. In 87 % of tumors, only low acute toxicity occurred at the end of radiotherapy. Late toxicity, if observed, was low in most patients. "Excellent" or "good" cosmesis was achieved in 94 % of tumors at last follow-up.

CONCLUSIONS:

Our radiotherapy schedule achieves a very high local control rate and very good cosmetic and functional results. This fractionation can be recommended as a standardized radiotherapy treatment for basal cell carcinoma of the face and head.

Basal Cell Radiotherapy

Radiotherapy of carcinomas of the skin overlying the cartilage of the nose: our experience in 671 lesions.

Caccialanza M et.al Eur Acad Dermatol Venereol. 2009 Sep;23(9):1044-9

J Eur Acad Dermatol Venereol. 2009 Sep;23(9):1044-9.

Abstract

BACKGROUND: The skin overlying the nose cartilage is a particularly frequent localization of skin carcinoma (about 25% of all carcinomas occurring on the head and neck). It is therefore of great practical interest to identify the best therapy, able to combine effectiveness with a good cosmetic and functional result.

OBJECTIVE: To verify both the therapeutic effectiveness of dermatologic radiotherapy and its 'toxicity' in the treatment of a large number of skin carcinomas overlying the cartilage of the nose.

METHODS: A retrospective study was done on 671 basal and squamous cell carcinomas treated by kilovoltage radiotherapy in the period 1972-2007.

RESULTS: The mean follow-up time was 38.016 months (range, 1-351 months). The 5-year cure rate was 88.09%. Cosmetic results were evaluated as 'good' or 'acceptable' in 96.84% of the treated lesions in complete remission. So far, no complication or sequelae to the radiologic treatment have been observed.

CONCLUSION: Dermatologic radiotherapy showed to be a safe, effective and non-invasive method, superior, on the basis of the literature data, to any other available therapeutic modality in the management of basal and squamous cell skin carcinomas localized over the nasal cartilages.

Comment: I think Moh's surgeons would say that their cure rates are higher, but then, this group may include very complex lesions that were not amenable to Moh's or that would have left significant defects.  One would need to review this article carefully. DJE