Jeremy Khong1, Peter Gorayski2, Daniel Roos3. 1. MBBS, Radiation Oncology Registrar, Department of Radiation Oncology, Royal Adelaide Hospital, SA. 2. BSc (Hons), BMBS, FRACGP, FRANZCR, Radiation Oncologist, Department of Radiation Oncology, Royal Adelaide Hospital, SA; Associate Professor, University of South Australia, SA. 3. BSc (Hons), Dip Ed, MBBS, MD, FRANZCR Senior Radiation Oncologist, Department of Radiation Oncology, Royal Adelaide Hospital, SA; Professor, School of Medicine, University of Adelaide, SA.
Abstract
BACKGROUND: Skin cancer is the most common malignancy that is managed in general practice, and non-melanoma skin cancer (NMSC) comprises the vast majority of presentations. Radiation therapy (RT) plays an important part in the management of NMSC and may be used as definitive treatment for low-risk cancers, as an adjuvant treatment for high-risk disease or alone for inoperable cases. OBJECTIVE: The aims of this article are to discuss: 1) types of RT; 2) role of RT, including its advantages and disadvantages; 3) side effects (toxicity) of RT; 4) outcomes from RT; 5) low- versus high-risk NMSCs and 6) some guidelines for general practitioners on when to refer patients for consideration of RT. DISCUSSION: The primary goal of treatment for NMSC is to cure the patient, and a secondary goal is to provide the best cosmetic and functional result with the minimum impact on quality of life. In deciding what modality of treatment to use, clinicians will need to take into account the site of the tumour, clinical stage, histological subtype and any high-risk features, patient comorbidities as well as patient preferences. RT provides a safe and effective alternative to surgery in select cases and is particularly useful for the elderly or where surgery might have a negative impact on function or cosmesis.
BACKGROUND:Skin cancer is the most common malignancy that is managed in general practice, and non-melanoma skin cancer (NMSC) comprises the vast majority of presentations. Radiation therapy (RT) plays an important part in the management of NMSC and may be used as definitive treatment for low-risk cancers, as an adjuvant treatment for high-risk disease or alone for inoperable cases. OBJECTIVE: The aims of this article are to discuss: 1) types of RT; 2) role of RT, including its advantages and disadvantages; 3) side effects (toxicity) of RT; 4) outcomes from RT; 5) low- versus high-risk NMSCs and 6) some guidelines for general practitioners on when to refer patients for consideration of RT. DISCUSSION: The primary goal of treatment for NMSC is to cure the patient, and a secondary goal is to provide the best cosmetic and functional result with the minimum impact on quality of life. In deciding what modality of treatment to use, clinicians will need to take into account the site of the tumour, clinical stage, histological subtype and any high-risk features, patient comorbidities as well as patient preferences. RT provides a safe and effective alternative to surgery in select cases and is particularly useful for the elderly or where surgery might have a negative impact on function or cosmesis.