How would you manage a large area of multiple, recurrent cutaneous squamous cell carcinomas of the scalp with ulcerations and non-healing areas despite cryotherapy, multiple Mohs procedures, and 5-FU?

Would your management be affected knowing the patient is on hydroxyurea?

Answer from: Radiation Oncologist at Academic Institution

Consider sending the patient to medical oncology for evaluation for cemiplimab. Large areas of the scalp can also be treated by making a 1 cm "cap" of bolus and utilizing VMAT to cover scalp soft tissues, with elective coverage of nodes and perineural pathways if indicated.

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Radiation Oncologist at Iowa City Cancer Treatment Center
One should be very careful to avoid skull bone nec...

Answer from: at Academic Institution

Radiation therapy, possible with the addition of cemiplimab (Libtayo). Hydroxyurea should have no effect on either therapy.

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How would you manage a large area of multiple, recurrent cutaneous squamous cell carcinomas of the scalp with ulcerations and non-healing areas despite cryotherapy, multiple Mohs procedures, and 5-FU?

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