Hypofractionated radiotherapy for invasive squamous cell carcinoma of the scalp in the elderly: Efficacy and tolerance, preliminary results

J Jacques; S Renard; N Demogeot; J C Faivre; D Peiffert

doi:10.1016/j.canrad.2023.01.003

Hypofractionated radiotherapy for invasive squamous cell carcinoma of the scalp in the elderly: Efficacy and tolerance, preliminary results

Cancer Radiother. 2023 Jun;27(4):290-295. doi: 10.1016/j.canrad.2023.01.003. Epub 2023 May 11.

Authors

J Jacques¹, S Renard², N Demogeot³, J C Faivre², D Peiffert²

Affiliations

¹ Radiation Department, institut de cancérologie de Loraine Alexis-Vautrin, Academic Department of Radiation Therapy and Brachytherapy, 6, avenue de Bourgogne, CS 30519, 54511 Vandœuvre-lès-Nancy, France. Electronic address: j.jacques@nancy.unicancer.fr.
² Radiation Department, institut de cancérologie de Loraine Alexis-Vautrin, Academic Department of Radiation Therapy and Brachytherapy, 6, avenue de Bourgogne, CS 30519, 54511 Vandœuvre-lès-Nancy, France.
³ Radiation Department, institut de cancérologie de Loraine Alexis-Vautrin, Academic Department of Radiation Therapy and Brachytherapy, 6, avenue de Bourgogne, CS 30519, 54511 Vandœuvre-lès-Nancy, France; Radiation Department, centre Émile-Durkheim, Épinal, France.

PMID: 37179219
DOI: 10.1016/j.canrad.2023.01.003

Abstract

Purpose: Skin squamous cells carcinomas (SCC) are frequently tumor, especially in the elderly population. Surgical excision is the standard treatment. But for patients suffering large tumor or/with comorbidity, a conservative approach with irradiation can be proposed. The hypofractionated schedule is used to shorten the overall treatment time with same results and without compromising therapeutic outcomes. The aim of this study is to assess the efficacy and tolerance of hypofractionated radiotherapy for invasive SCC of the scalp in elderly.

Patients and methods: We included patients suffering from SCC of the scalp and treated by hypofractionated radiotherapy at the Institut de cancérologie de Lorraine or centre Émile-Durkeim d'Épinal, from January 2019 to December 2021. Characteristics of patients, size of the lesion and side effects were collected retrospectively. Tumor size at 6 months corresponded to the primary endpoint. Toxicity was collected for the secondary endpoint.

Results: Twelve patients with a median age of 85 years old were included. The mean size was 4,5cm with a bone invasion in 2/3 of cases. Radiotherapy was delivered after surgical excision for half of the patient. The dose delivered was 54Gy in 18 daily fractions size. Six months after irradiation: 6/11 patients had no residual lesion, 2/11 had a partial response with a residual lesion of about 1cm. 3 patients presented local recurrence. One patient died within 6 months of radiotherapy because of another comorbidity. In total, 25% had presented a grade 3 acute radiation dermatitis, no grade 4 toxicity.

Conclusion: Short term of moderately hypofractionated schedule radiotherapy was a success with complete or partial response for more than 70% of the patients in squamous cell carcinomas. There is no major side effect.

Keywords: Carcinomes épidermoïdes; Elderly; Hypofractionated; Radiotherapy; Radiothérapie hypofractionnées; SCC; Scalp; Sujets âgés; Vertex.

MeSH terms

Aged
Aged, 80 and over
Carcinoma, Squamous Cell* / radiotherapy
Carcinoma, Squamous Cell* / surgery
Humans
Radiation Dose Hypofractionation
Radiodermatitis* / etiology
Retrospective Studies
Scalp
Treatment Outcome