Skin care and beyond: Radiation therapy’s role in skin cancer treatment

Welcome to the June issue of Applied Radiation Oncology! With summer’s much anticipated return, June marks an apropos time to focus on skin cancer, which remains the most common cancer. We are pleased to provide treatment updates for very common and less common cutaneous malignancies.

Our first update is A review of the role of external-beam radiation therapy (EBRT) in nonmelanomatous skin cancer (NMSC), in which authors from the Cleveland Clinic discuss radiation therapy’s important role in both the definitive and postoperative management of NMSC, especially in patients with high-risk disease. This informative article, which offers SA-CME credit, reviews common indications, targeting and dosing, techniques, and outcomes.

In Mycosis fungoides involving head and neck mucosal sites: Review of the literature, clinicians from Henry Ford Hospital review all reported cases of this rare manifestation, along with two cases from their facility (59 total). By describing risks, disease patterns, and appropriate treatment options, this comprehensive and enlightening review, which also offers SA-CME credit, will aid in treatment decision-making and more accurately predicting outcomes in affected patients.

Complementing this review is the case report, Extensive cutaneous T-cell lymphoma and challenges with radiation treatment from authors at McMaster University in Ontario. The report presents a compelling summary of how volumetric modulated arc therapy’s novel rotational approach with photons can be used for treating extensive cutaneous disease involving uneven and curving surfaces to achieve local tumor control and provide excellent palliation with minimal dose to adjacent normal structures.

A second case report is Horner’s Syndrome following salvage stereotactic ablative radiotherapy (SABR) for recurrent laryngeal carcinoma with prior radiation and laryngectomy from authors at the University of Pittsburgh. They report on the development of Horner’s syndrome after use of salvage SABR for a patient who had undergone prior radiation therapy, which emphasizes the importance of following patients who undergo salvage treatments.

We are also pleased to present the research paper, Is adjuvant radiotherapy an alternative to regional node dissection in select patients with lymph node-positive melanoma? According to the authors from University of Florida, Gainesville, the answer appears to be yes. Based on their limited but promising experience, adjuvant RT for subclinical regional disease in lymph node-positive melanoma may result in durable regional control without the potential added morbidity of a completion lymph node dissection (CLND). Additionally, the risk of complications is likely lower than after a CLND and postoperative RT.

Rounding out the skin cancer focus is the Technology Trends article, Electronic brachytherapy for skin cancer: Problems and progress, which recaps self-referral issues and related concerns, and reviews early data regarding positive outcomes for cosmesis, toxicity and short-term response.

We hope you enjoy our skin cancer focus, and wish you an enjoyable and memorable summer season!