Radiation therapy for carcinoma of the skin of the face and neck. Special considerations

Abstract

Approximately 300,000 new cases of carcinomas of the skin are diagnosed each year in the Unied States. The great majority of these lesions are on the skin of the face and neck. The proximity of these neoplasms to important structures such as the eyes, nose, and ears has prompted this discussion of the role of radiation therapy in their management. Most carcinomas of the skin of the nose and eyelids are basal cell carcinomas, while most tumors arising on the pinna are squamous cell carcinomas. Despite the fact that cutaneous carcinomas of the face and neck are essentially totally curable, hundreds of patients in the United States annually die or become horribly disfigured through neglect or improper treatment. Radiotherapy of cutaneous carcinomas can be rewarding when the proper care and expertise are applied. The radiation therapist is afforded an unusual opportunity to deal with a highly curable malignant neoplasm, but at the same time he can model his means to obtain the best aesthetic results. Many carcinomas of the skin are expeditiously and effectively cured by simple excision, but others, regardless of size, may be treated best by radiotherapy because of better aesthetic results. The use of acids, caustics, ormore » electrocoagulation offers no particular advantage and is seldom as satisfactory as a clean excision. The surgical procedure often may be an excisional biopsy, which offers the opportunity of adequate histopathologic study of the specimen. Various modalities of radiation therapy may be successfully utilized, but none has the elasticity and definite advantage of relatively low kilovoltage roentgen therapy.« less