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Radiotherapy effectively treated facial squamous cell carcinoma

Superficial radiotherapy is an effective and safe alternative to excision for cutaneous squamous cell carcinoma localized around the eyes and noses of patients for whom surgery would risk side effects, a study has reported.

In a retrospective study, researchers reviewed 179 patients (mean age, 69.5 years; 63% men) with 180 large cutaneous squamous cell carcinoma lesions (mean size, 3.5 cm²) treated with superficial radiotherapy (RTx) between 1960 and 2004 in Switzerland. One hundred seventy-seven lesions were primary; three were recurrent and excised before RTx.

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Lesions were treated with a mean dose fractionation of 4.6 Gy and a mean cumulative dose of 48.2 Gy during 11.4 sessions. Researchers associated tumor size and cumulative dose (P<.00001). Mean follow-up was 4.9 years.

Relapse-free survival was 95.8% and 80.4% after 1 and 10 years, respectively. By grade, relapse-free survival after 2 years was 94.8% in well-differentiated, 88.9% in moderately differentiated and 85.7% in poorly differentiated tumors.

Five-year relapse-free survival rates were 100%, 95.2% and 90.9% for lesions around the eyes, nose and cheeks, respectively. Significantly higher relapse rates (P=.025) were seen near the scalp and ears, with five-year relapse-free survival rates of 69.2% and 72.2% respectively.

“[Superficial RTx] is particularly favorable for elderly patients for whom surgery would be an increased health risk and if functional or cosmetic impairment is expected,” the researchers concluded.