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Advanced skin squamous cell carcinoma: role of radiotherapy
1MBBS (Hons), FRANZCR, PhD, MD is Senior Consultant Radiation Oncologist, North Coast Cancer Institute, Lismore and Professor of Radiation Oncology, University of Sydney, NSW.
Background:
We present the case of an elderly man who was referred with a neglected, highly advanced skin squamous cell carcinoma on his posterior chest wall. The cancer was causing difficult-to-control pain and malodour.
Objective:
The treatment and outcomes of local hypofractionated (6 Gray fractions) radiotherapeutic management of an advanced lesion are shown.
Discussion:
The treatment could not, for reasons of the radiation tolerance of the lungs, cover the entirety of the bulky cancer; ie. the radiotherapy was a balance between not exceeding lung tolerance and achieving adequate tumour coverage. Keeping the treatment simple was also important, as the aim of therapy was palliation, and the patient's ability to lie reproducibly still was compromised. Hence, he was treated with large, weekly fractions - such treatment is useful in the palliative setting, as it minimises patient discomfort and inconvenience. The treatment achieved significant tumour regression, complete relief of pain, arm lymphoedema and a large reduction in malodour.
