Radiotherapy of extensive basal and squamous cell carcinomas of the skin: Our experience on 131 cases treated in 13 years

Background. Extensive primitive malignant epithelial neoplasms of the skin (T₃-T₄), although representing a small percentage of all the malignant epithelial skin neoplasms, are a puzzling therapeutic problem, given the high recurrence rate and a relatively high associated mortality. Objective. To determine which therapy affords the best results with a favourable benefit/risk ratio, it is mandatory to have large clinical series, classified according to the international system of malignant tumor staging and endowed with an adequate follow-up. To this end we report the updated results of our experience obtained in 13 years and based on a retrospective study of a series of 131 patients affected by extensive primitive basal and squamous cell skin carcinomas and treated with radiotherapy. Materials and method. The patients were treated by means of orthovoltage radiotherapy. The total dose of ionizing radiations administered for field of irradiation was 60 Gy, with two weekly fractions of 5 Gy each in the patients treated with contact X-ray and soft X-ray therapy, and five fractions weekly of 2 Gy each in the patients who underwent half-deep X-ray therapy. Results. The mean follow-up was 31.87 months (range: 1-144 months). The five-year cure rate after the end of radiotherapy was 79% (116 cases with complete remission, 3 with partial remission, 9 with recurrence and 3 with failure of the treatment). Up to now the cosmetic results have been evaluated as good or acceptable in 88.79% of cases. No complications related to radiotherapy have been observed. Conclusions. Such results, obtained in a group of patients hard to treat with other techniques since their age, general conditions, localization and extension of the neoplasm, support the therapeutic effectiveness of dermatologic radiotherapy.