A radiotherapy technique for palliative total scalp irradiation

A scalp irradiation technique for palliative treatment of a squamous cell carcinoma was discussed. A patient with multiple cutaneous scalp lesions resulting in bleeding and pain was treated with a 3D conformal radiotherapy technique was performed with five 6 MV electron beams without shifting the field borders during the course of the treatment, due to the finality of the treatment (palliative intent). A reduction of planning and delivery complexity has been obtained not considering the junctioning problems. Nevertheless, the 90% of gross tumor volume (GTV) was covered by the 85% of prescription dose with a significant reduction of patient's symptoms (pain and bleeding). Our patient achieved a significant pain response and resolution of bleeding with this technique. Our study revealed that the scalp irradiation by means of electron beam without considering the junction problem is easy and effective for the palliative intent in elderly patients with squamous cell carcinoma.