Опухоли головы и шеи (Dec 2022)

Radiotherapy for cutaneous squamous cell carcinoma: current standards and outlooks

  • A. R. Gevorkov,
  • A. V. Boyko,
  • A. P. Polyakov,
  • A. V. Chernichenko,
  • V. A. Gerasimov,
  • I. A. Meshcheryakova,
  • A. D. Kaprin

DOI
https://doi.org/10.17650/2222-1468-2022-12-3-53-70
Journal volume & issue
Vol. 12, no. 3
pp. 53 – 70

Abstract

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Cutaneous squamous cell carcinoma accounts for 20 % of all malignant non-melanoma skin tumors, which is one of the most common cancers worldwide. Antitumor treatment is usually very effective: cure rate reaches 90 %, while local recurrence rate is 25 %. The main treatment option for primary skin cancers is surgery. The most significant risk factors for locoregional recurrence include tumor location (head and neck), size (>2 cm), depth of invasion (>4 mm), tumor differentiation grade, perineural invasion, immune system disorders (immunosuppression), severe concomitant diseases, and previous treatment.In patients with advanced cutaneous squamous cell carcinoma, 1-year, 2-year, and 3-year survival rates are 50–80, 30–35 and 15–16 %, respectively. Radiotherapy is a radical treatment option that increases the 5-year survival rate to 90 % and ensures good cosmetic results in 80 % of cases. There are 3 main variants of radiotherapy for cutaneous squamous cell carcinoma: sole radiotherapy according to a radical program, adjuvant radiotherapy in combination with surgery, and palliative radiotherapy. most frequently, radiotherapy is used as part of adjuvant postoperative treatment and is not initially considered as a sole conservative treatment for cutaneous squamous cell carcinoma patients below 45 years of age with resectable tumors, especially high-risk tumors. palliative radiotherapy is an affordable and effective method for combating painful symptoms; moreover, it often provides long-term local control.

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