Purpose: To retrospectively review patterns of failure, cosmesis, and outco
mes according to treatment modality of patients with histologically confirm
ed epithelial skin cancer.
Methods and Materials: The records of 468 patients having 531 lesions were
analyzed; 389 basal cell carcinomas and 142 squamous cell carcinomas were t
reated, 167 of which were recurrent tumors. Median follow-up was 5.8 years.
Electron beam irradiation was used in 19%, superficial x-rays in 60%, a co
mbination of electron beam and superficial x-rays in 20%, and megavoltage p
hotons in <2%.
Results: The overall local tumor control rate was 89%; it was 93% for previ
ously untreated lesions and 80% for recurrent lesions. Patients with basal
cell carcinoma had a 92% overall control rate; patients with squamous cell
carcinoma 80%. Multivariate analysis showed that local failure was related
to the daily dose fractionation. The maximal diameter of the lesion and pat
hologic tumor type were also significant (p less than or equal to 0.01). Tr
eatment type, patient age, and treatment duration were not significant. Ove
rall, 92% of the treated population with cosmesis data had excellent or goo
d results. The overall complication rate was 5.8%, consisting primarily of
soft-tissue necrosis.
Conclusions: Radiotherapy remains an excellent treatment modality for epith
elial skin cancer. Local tumor control, cosmesis, and complications are rel
ated to the size of the primary lesion. Recurrent lesions fared worse, and
therefore treatment at the earliest possible stage is strongly recommended.
(C) 2001 Elsevier Science Inc.