The role of radiation therapy in the treatment of early-stage skin cancer

Abstract

Introduction. Radiation therapy remains one of the main methods of radical treatment of early-stage skin cancer. Its position in combination and comprehensive treatment has changed significantly as improvements of radiotherapy techniques and introduction of modern technologies led to increased effectiveness and comfort of the method and allowed to achieve better prognostic outcomes.Aim. To evaluate the role of radiotherapy in treatment of patients with early-stage skin cancer (T1–2N0M0).Materials and methods. A retrospective and prospective analyses of data from 1049 patients with early-stage skin cancer were performed. In 527 (50.23 %) cases, the tumor was localized mainly on the head and neck: 48 % of patients had nonkeratinizing squamous cell carcinoma of the skin, 7.59 % of patients had keratinizing squamous cell carcinoma, 44.41 % of patients had basal cell carcinoma.Results. Data from 527 patients (51.04 % man and 48.96 % women) with early-stage skin cancer (T1–2N0M0) who received treatment and are registered at the Republican Oncological Scientific Center of the Ministry of Health and Social Protection of the Tajikistan Republic were analyzed. The disease was more common in patients aged between 60 and 90 years. The main factor in stage determination was tumor size in accordance with the Tumor, Nodus and Metastasis (TNM) classification. In 240 (46.54 %) patients, the size of primary tumor was less than 2 cm in the largest diameter (T1N0M0), in 287 (54.46 %) patients its maximal size was between 2 and 4 cm (T2N0M0). Selection of treatment method was mainly based on morphological characteristics and location of the tumor. In 121 (50.42 %) patients with skin cancer T1N0M0, radiation therapy was performed as monotherapy in a radical program; in 88 (36.37 %) patients in combination with cobalt therapy and surgery; in 23 (9.59%) patients in combination with cobalt therapy, polychemotherapy and surgery; in 8 (3.41%) patients in combination with cobalt therapy and polychemotherapy.The capabilities of radiation therapy both as monotherapy and in combination with other treatment methods before and after surgical treatment present ample opportunities for clinicians to achieve good outcomes. The use of radiation therapy as monotherapy in a radical program in patients with T1N0M0 stage skin cancer is effective in 96.4 % of cases, in patients with stage T2N0M0 the effectiveness can reach 91.2 %.Conclusion. Radiation therapy can be successfully used in treatment of early-stage skin cancer along with other methods. Its use both independently and as part of combination and comprehensive therapy allows to achieve reliable treatment outcomes. Adequate selection of radiation therapy option in treatment of early-stage skin cancer is the key to longterm clinical remission and improvement of patients’ quality life.