Xstrahl In Action: Orthovoltage X-rays for Postoperative Treatment of Resected Basal Cell Carcinoma in the Head and Neck
Surgery is the gold standard for treating basal cell carcinomas (BCCs), however in cases of positive tumor margins or recurrent disease, postoperative adjuvant or salvaging therapy is prefered to achieve good local control.
In their paper “Orthovoltage X-rays for Postoperative Treatment of Resected Basal Cell Carcinoma in the Head and Neck Area” Duinkerken CW, Lohuis PJFM, et al, retrospectively investigate and report on local control and toxicity of postoperative treatment of residual or recurrent BCCs in the head and neck area after being treated with orthovoltage X-rays.
Sixty-six surgically resected residual or recurrent BCCs in the head and neck region were irradiated postoperatively by means of orthovoltage X-rays at the Netherlands Cancer Institute between January 2000 and February 2015, using an Xstrahl 300 system. After a median follow-up duration of 30.5 months, only 5 recurrences were reported. The 5-year local control rates at 1, 3, and 5 years were 100%, 87%, and 87%, respectively. The 5-year local control rate was 92% for immediate postoperative radiotherapy of incompletely resected basal cell carcinomas, 90% for recurrences after 1 previously performed excision, and 71% for multiple recurrences, namely, a history of more than 1 excision. Acute toxicity healed spontaneously within 3 months and late toxicities were mild.
It was concluded that radiotherapy proved an excellent alternative for re-excision in case of incompletely resected or recurrent BCCs that are at risk of serious functional and cosmetic impairments after re-excision, with a 5-year local control rate of 87% and a low toxicity profile.