Matthiesen Chance, Thompson Spencer, Ahmad Salahuddin, Herman Terence, Bogardus Carl
Department of Radiation Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
J Dermatol Case Rep. 2010 Dec 19;4(3):47-9. doi: 10.3315/jdcr.2010.1051.
Patients with locally advanced skin cancer often present an uncommon and unique treatment challenge. Surgical resection and reconstruction with an acceptable cosmetic outcome is difficult for larger lesions with deep infiltration into subcutaneous tissues. Radiation therapy has been shown to be an effective treatment modality for advanced non-melanoma skin cancers, with cure rates ranging 50-100%. In this case report, we discuss the efficacy and outcome of treatment using an advanced radiation therapy technique to a large T4 squamous cell carcinoma of the face.
The patient responded favorably to the advanced radiation treatment course, and achieved a clinical complete response to therapy. No further intervention was required. Advanced radiation therapy techniques offered treatment advantages that resulted in greater tumor dose escalation and minimizing of patient morbidity.
Patients with advanced skin cancers of the head and neck should be considered for definitive radiation therapy using advanced treatment techniques. The use of definitive RT only for tumors deemed unresectable, or for inoperable patients at presentation deserves reconsideration. Further investigation is warranted.
局部晚期皮肤癌患者常常带来罕见且独特的治疗挑战。对于浸润至皮下组织较深的较大病灶，要实现可接受的美容效果进行手术切除和重建很困难。放射治疗已被证明是晚期非黑色素瘤皮肤癌的一种有效治疗方式，治愈率在50%至100%之间。在本病例报告中，我们讨论了使用先进放射治疗技术治疗面部巨大T4期鳞状细胞癌的疗效和结果。
患者对先进放射治疗疗程反应良好，实现了治疗的临床完全缓解。无需进一步干预。先进放射治疗技术提供了治疗优势，可实现更高的肿瘤剂量递增并将患者发病率降至最低。
对于头颈部晚期皮肤癌患者，应考虑使用先进治疗技术进行确定性放射治疗。仅将确定性放疗用于被认为无法切除的肿瘤或就诊时无法手术的患者值得重新考虑。有必要进行进一步研究。
