Abstract
IntroductionTreatment of inoperable cutaneous squamous cell carcinoma (cSCC) of the head and neck region is still debated.Case reportWe report an original case of cure of cSCC of the head and neck region with weekly hypofractionated radiation therapy with megavoltage electrons prescribed for locally advanced inoperable disease.ResultsWeekly hypofractionated radiotherapy assured complete regression and was well-tolerated.ConclusionThe real efficacy of this treatment in the therapeutic arsenal remains to be defined. A clinical trial is ongoing to test the use of 8 weekly fractions of 8 Gy hypofractionated RT regimens in non-resectable cSCC cases.
Highlights
Treatment of inoperable cutaneous squamous cell carcinoma of the head and neck region is still debated
Its estimated cases for 2020 cannot be predicted because incidence data are not collected by most cancer registries worldwide [2]. cutaneous squamous cell carcinoma (cSCC) predominantly derives from the malignant proliferation of epidermal keratinocytes
We report for the first time a complete response in a elderly patient with a non-resectable cSCC of the cheek treated with weekly hypofractionated radiation therapy with megavoltage electrons
Summary
Cutaneous squamous cell carcinoma (cSCC) represents the second most frequent form of non-melanoma skin cancer, with a rising incidence in elderly population (year by year more than 7%) [1]. With high borders, making it difficult to identify the optimal electron driver energy In this context, we have chosen to prioritize the dose to deeper tumor layers resulting in cold spot beneath the proximal surface of the lesion margins and hot spot in the distal surface. We have chosen to prioritize the dose to deeper tumor layers resulting in cold spot beneath the proximal surface of the lesion margins and hot spot in the distal surface This confirms the concept that there is a high cell turnover, continuously renewing skin containing rapidly proliferating and maturing cells. The strength of recommendation is strong, the quality of evidence is low With this in mind, if proved safe, effective and reliable, the 8 weekly fractions of 8 Gy hypofractionated regimen has the potential to become a standard approach for elderly cSCC patients management. In order to standardize the proposed radiation fractionation scheme, a clinical trial for use of 8 weekly fractions of 8 Gy hypofractionated radiotherapy with megavoltage electrons in the elderly cSCC setting is ongoing
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