External beam radiotherapy for basal cell carcinoma. Local control and cosmetic outcome

Citation
Mh. Seegenschmiedt et al., External beam radiotherapy for basal cell carcinoma. Local control and cosmetic outcome, STRAH ONKOL, 177(5), 2001, pp. 240-246
Citations number
35
Language
TEDESCO
art.tipo
Article
Categorie Soggetti
Oncology
Journal title
STRAHLENTHERAPIE UND ONKOLOGIE
ISSN journal
0179-7158 → ACNP
Volume
177
Issue
5
Year of publication
2001
Pages
240 - 246
Database
ISI
SICI code
0179-7158(200105)177:5<240:EBRFBC>2.0.ZU;2-U
Abstract
Background: The basal cell, carcinoma which is often occurring in the elder ly can be well treated by surgery. For Large and recurrent Lesions and in c osmetically difficult Locations external beam radiotherapy provides an equa lly effective treatment alternative. Patients and Methods: From 1986 to 1999, 60 females and 39 males received p rimary radiotherapy for a total of 127 histologically verified basal cell c arcinoma Lesions. Tumors were mostly Localized in the face at the temple, n ose and forehead. Radiotherapy was applied with orthovoltage equipment and energies of up to 100 kV, Single doses ranged from 2 to 5 Gy related to the 80%-isodose depth. Weekly doses ranged from 8 to 25 Gy and total doses fro m 25 to 60 Gy. The mean follow-up period was 36 +/- 21 months. The acute se quelae were scored according to CTC criteria. Radiogenic Late effects as si ngle events were related to the radiation portal. Results: 3 months after treatment all besides one patient (99%) experienced complete tumor remission (CR). In all cases, acute radiation reaction occu rred within the radiation portal: CTC Grade 1 in 100%, CTC Grade 2 in 54% a nd CTC Grade 3 in 30% of the cases. ALL side effects regressed under simple Local measures without further complications. Late sequelae were observed in three cases. Overall cosmetic outcome was good to excellent in almost al l patients (98%). In two cases (2%) a Local recurrence was observed 6 and 2 0 months after radiotherapy. Conclusion: External beam (orthovoltage) radiotherapy is very effective and yields high tumor control rates and good cosmetic results in long-term fol low-up. Former dermatological treatment concepts should be replaced by an I CRU-based radiophysical dose prescription and should respect the newer radi obiological fractionation principles.