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Radiation Oncology • Melanoma/Skin Cancer
What is the role of radiotherapy in medically inoperable, large and or recurrent aggressive basal cell or squamous cell cancer of the skin in high risk areas?
Should definitive radiotherapy be used as a standard approach? If so, what are the dose and technique considerations in treating these complicated tumors, ie, around the wrist or on the anterior shin with poor vascular supply? What is the risk of wound complications?
Answer from: Radiation Oncologist at Academic Institution
Ideally 60Gy in 30 fractions + chemotherapy would be preferred. However, due to other medical conditions/etc. that may not be feasible. An example of compromise, complete resolution and control to scalp lesion that eroded to dura was achieved with 36 Gy in 6 fractions.
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Answer from: Radiation Oncologist at Academic Institution
When treating small to moderate size skin cancers in an area with good circulation (face, trunk, upper extremity) my standard regimen for BCC is 4500 cGy in 15 fractions, and for SCC I use 4800 cGy in 16 fractions. For large tumors I use 5000 cGy in 20 fractions for both histologies, and this is als...
Answer from: Radiation Oncologist at Community Practice
What dose fractionation would you use for an elderly and frail but mentally very functional woman with a 7 x 7 x 1.5 cm thick vertex SCCA with calvarial involvement? Similar to the case above but quite large.