Purpose
Squamous cell carcinoma (SCC) is the second most common cutaneous malignancy, and a rise in incidence of SCCs have been noted. The sun-exposed head and neck region is a common site for development of cutaneous SCC. Whilst the majority of patients achieve good outcomes following complete excision, approximately 5% of patients would have metastases to the regional lymph nodes at diagnosis.[1]
Adjuvant radiotherapy is an established component in the management of metastatic cutaneous squamous cell carcinoma (SCC) involving the parotid gland.[2-3] Radiotherapy technique, dose and...
Methods and materials
We performed a retrospective review of patients with metastatic cutaneous SCCs who underwent parotidectomy with or without ipsilateral neck dissection. Demographics, clinical data and treatment details were collected from an intuitional electronic database. Individual patient-level radiotherapy technique, volumes and doses were reviewed. Patients were included in our study if they underwent curative intent parotidectomy, with or without neck dissection, followed by adjuvant radiotherapy. We included patients whose primary site was either confirmed or most likely to be cutaneous head and neck lesions. Patients who presented...
Results
Between July 2008 and July 2018, 60 patients met our inclusion criteria. Median follow up duration was 32.7 months. The mean age was 66.4 years. The majority of patients (49 patients) received full neck irradiation. All patients received adjuvant radiotherapy. The average dose was 60.558Gy (Standard Deviation (SD): 4.807, range 44-69Gy) to the parotid bed was and 56.561 (SD: 4.787, range 40-64.5Gy) to the ipsilateral neck. The most common dose fractionation was 60 Gray in 30 fractions, which was used in 29 patients.
Overall, there...
Conclusion
We demonstrated high loco-regional control rates with routine use of comprehensive adjuvant radiotherapy. The presence of LVI was identified as a strong predictor for recurrence. Further analysis will help to define optimal radiation dose and techniques.
References
1. Joseph MG, Zulueta WP, Kennedy PJ. SQUAMOUS CELL CARCINOMA OF THE SKIN OF THE TRUNK AND LIMBS: THE INCIDENCE OF METASTASES AND THEIR OUTCOME. ANZ J Surg. 1992 Sep;62(9):697–701.
2. Veness MJ, Morgan GJ, Palme CE, Gebski V. Surgery and Adjuvant Radiotherapy in Patients with Cutaneous Head and Neck Squamous Cell Carcinoma Metastatic to Lymph Nodes: Combined Treatment Should be Considered Best Practice: The Laryngoscope. 2005 May;115(5):870–5.
3. Porceddu SV, Daniels C, Yom SS, Liu H, Waldron J, Gregoire V, et al. Head and...