Role of radiation therapy for facial skin cancers.

Radiation therapy is one of many modalities that should be considered and explained to patients with basal cell carcinomas and squamous cell carcinomas of the head and neck (Fig. 2). Control rates for appropriately selected patients should exceed 90% and historically are comparable with most surgical resections. For locally advanced T4 lesions, a combined modality approach will give the best chance at local control. Postoperative radiation therapy is indicated in patients with advanced lesions, positive margins, lymph node metastasis, or perineural invasion. We advocate the discussion of this treatment modality with every such patient, even if the treating physician does not recommend it. Only then can a patient provide genuine "informed consent" for treatment.