The role of radiotherapy for large and locally advanced non-melanoma skin carcinoma

Background: The role of radiotherapy for large and locally advanced non-melanoma skin cancer is unclear. In this report, we aimed to review our institutional experience with patients treated with radiation therapy for T2–T4 NMSC and analyze outcomes. Methods: Seventy patients and 85 lesions were reviewed who received radiotherapy. Fifty-six lesions (65.9%) were untreated, 17 (20.0%) recurrent, and 12 (14.1%) post-operative. Forty-three (50.6%) were staged T2, 20 (23.5%) T3, and 22 (25.9%) T4. Median follow-up was 20 months. Results: Thirty-nine living patients (59.0%) had no evidence of disease, of which 35 (89.7%) required no therapy following radiotherapy. Twenty-seven patients (41.0%) died, of which 10 deaths were attributed to disease progression. Achievement of complete response (CR) to all therapy and radiotherapy alone was, respectively, 95.3% and 86% for T2, 70% and 65% for T3, and 68.2% and 59.1% for T4. Statistically significant factors for CR included basal cell histology (p = 0.005) and tumour stage T2 (0.01). Conclusions: Radiotherapy for T2–T4 NMSC is effective. Basal cell histology and T2 are statistically favoured to achieve CR to radiotherapy alone.