Selective use of radiation therapy for neoplasms of the skin

Radiation therapy is preferable treatment for a minority of basal cell and epidermoid carcinomas of the skin. Proper use exploits the inherent advantage of preservation of function and cosmesis. Therefore, many cancers involving the eyelid, canthus, nose, nasolabial fold, pinna, ear canal, vermilion surface of the lower lip and skin of the chin can be advantageously treated by radiation therapy as compared to surgery, if pretreatment destruction of normal tissue is minimal. Although irradiation is equally effective, surgery is more expeditious for small lesions and cancers at other sites, which can be excised and followed by primary closure, and for large lesions if reconstruction will be required after destruction of the tumor. Radiation therapy, less frequently, can control cancers too extensive for reasonable resection. This indication should be clearly distinct from the selected use in less extensive, resectable cancers. Radiation therapy can be effective, and usually is preferable treatment, for several other primary neoplasms of skin such as mycosis fungoides and Kaposi's sarcoma.