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Radiotherapy for basal cell carcinoma of the medial canthus region
Erika L Swanson1, Robert J Amdur, William M Mendenhall
1Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA.
Objectives/Hypothesis:
To report outcome for patients treated with radiotherapy (RT) for basal cell carcinoma of the medial canthus.
Study Design:
Retrospective review.
Methods:
Thirty-three patients treated with RT at the University of Florida between 1965 and 2005 for basal cell carcinoma of the medial canthus were retrospectively reviewed. RT was the primary treatment for gross disease in 70% of patients and for positive margin after resection in 30%. The prescribed dose was 50 to 60 Gy at 2.0 to 2.5 Gy per fraction.
Results:
Surviving patients were followed for a median of 14 years. Tumor recurred at the primary site in 10%. There were no regional recurrences or distant metastases. The local control rate was 100% in patients treated with surgery followed by RT for positive margins. In patients treated with RT alone, the local control rate was 94% with de novo lesions and 67% if the lesion was recurrent after prior surgery. Cause-specific survival was 95% at 10 years; overall survival was 52% at 10 years. There were no severe complications. Chronic epiphora was present in 21% and chronic dry eye symptoms in 3%.
Conclusions:
With the proper technique, RT produces excellent results in several of these patients. Patients with recurrent tumors and gross disease at the time of RT have a suboptimal cure rate. Our plan is to increase the RT dose to 64.8 Gy at 1.8 Gy per fraction.
