ASTRO Issues Recs for Radiation Tx of Basal, Squamous Cell Carcinoma

In an executive summary of an American Society for Radiation Oncology clinical practice guideline, published online in Practical Radiation Oncology, recommendations are presented for the use of radiation therapy (RT) for basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC).

Anna Likhacheva, M.D., from Sutter Medical Center in Sacramento, California, and colleagues conducted a systematic literature review to address five key questions focused on indications for RT in the definitive and postoperative setting for BCC and cSCC.

The researchers developed recommendations using a predefined consensus-building method. Definitive RT is recommended as primary treatment for patients with BCC and cSCC who are not surgical candidates. In situations in which adequate resection can lead to a less-than-satisfactory cosmetic or functional outcome, RT is conditionally recommended, with an emphasis on shared decision-making. The authors provide a number of indications for RT in the postoperative setting, including for patients at high risk for recurrence and when there is evidence of spread to nerves, while distinguishing the strength of the recommendations between BCC and cSCC. A range of appropriate dose-fractionation schemes are suggested for treatment of primary and nodal volumes in definitive and postoperative scenarios. The guidelines recommend against concurrent use of carboplatin with adjuvant RT.

"Whenever possible, patient outcomes should be collected as part of clinical trials and prospective registries to bolster the overall quality of data on this topic," the authors write.

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