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Efficacy, cosmesis and skin toxicity in a hypofractionated irradiation schedule for cutaneous basal cell carcinoma of the head and neck area

December 1, 2012

Aim

To evaluate efficacy and acute and chronic toxicity of a hypofractionated irradiation schedule in elderly patients with basal cell carcinoma (BCC) of the skin.

Materials and methods

Between February 2005 and November 2011, 42 retrospectively selected patients diagnosed with skin BCC of the head and neck area were treated with three-dimensional conformal radiotherapy (3DCRT) as an adjuvant therapy. Radiotherapy schedule was 5 × 600 cGy once weekly. Acute and late radiotherapy skin toxicity and cosmetic outcome were assessed in long-term follow up according to European Organization Research Treatment of Cancer/Radiotherapy Oncology Group (EORTC/RTOG) criteria, while cosmesis was evaluated by a plastic surgery expert.

Results

Patients’ median age was 78 years, while median follow up was 15 months. Only two local recurrences were observed at 15 and 32 months, respectively, post-3DCRT. Grade I, II and III acute skin toxicity was observed in 30/42, 9/42 and 2/42 patients, respectively. Late toxicity as grade I and II was observed in 14/42 and 2/42 patients, respectively. ‘Excellent’ or ‘good’ cosmesis was achieved in 30/42 and 12/42 patients, respectively.

Conclusion

Our irradiation schedule achieved very high local control rate with very good cosmetic and functional results, and it could be an alternative radiotherapy treatment for elderly patients with BCC of the head and neck area.

V Kouloulias, J Kouvaris, E Mosa, J Georgakopoulos, K Platoni, O Papadopoulos, E Papadavid, A Zygogianni, D Rigopoulos, C Antypas, I Beli, F Karantonis & N Kelekis.

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