Radiotherapy for locally advanced basal cell and squamous cell carcinomas of the skin

Purpose: To determine the outcomes of patients with locally advanced basal cell and squamous cell carcinomas of the skin treated with radiotherapy. Methods and Materials: A retrospective review of the outcomes of patients with basal cell and squamous cell carcinomas treated with radical radiotherapy was conducted. Patients with T2 or more advanced disease or nodal disease were included. The clinical course after radiotherapy and factors that can affect locoregional control were analyzed. Results: Four-year locoregional controls for basal cell and squamous cell carcinomas are 86% and 58%, respectively. The median time to recurrence of basal cell and squamous cell carcinomas are 40.5 months and 5.0 months, respectively. No deaths resulted from basal cell carcinomas, but 65% (30/46) of all patients with locoregional recurrent squamous cell cancers died from the disease. Uncontrolled locoregional disease was the cause of death in 81% (30/37) of all patients who died of squamous cell cancers. Conclusions: Basal cell carcinomas can be well controlled with radiotherapy even when locally advanced. Squamous cell carcinomas have a much poorer outcome and can recur quickly after radiotherapy. Locoregional failure remains the predominant cause of death in recurrent squamous cell carcinomas. (C) 2004 Elsevier Inc.