Radiotherapy management for squamous cell carcinoma of the nasal skin: the Princess Margaret Hospital experience

Int J Radiat Oncol Biol Phys. 2002 Mar 15;52(4):973-9. doi: 10.1016/s0360-3016(01)02752-3.

Abstract

Purpose: To evaluate the outcome of radiotherapy (RT) for squamous cell carcinoma (SCC) of the nasal skin.

Materials and methods: The charts of 100 patients referred and treated with RT during 1982 to 1993 for SCC of nasal skin were reviewed. Most patients (81%) were treated with orthovoltage X-rays. In general, lesions </=2 cm were treated to 35 Gy in 5 fractions. For tumors 2-5 cm, 45 Gy in 10 fractions was commonly used. Lesions >5 cm or those associated with bone or cartilage invasion were typically treated to 50 Gy in 20 fractions. Six patients were lost to follow-up, leaving 94 patients assessable for local or regional failure analysis. Using the UICC staging system, the T stage at first presentation was as follows: T1, 60 patients; T2, 11 patients; T3, 0 patients, T4, 7 patients; TX, 16 patients. Only 1 patient had regional lymph node disease at presentation. Thirty-one patients were treated with surgery, followed by RT. Sixty-three patients were treated with primary RT.

Results: The local relapse-free rate was 90% and 85% at 2 and 5 years, respectively. The actuarial 2 and 5-year overall survival rate was 75% and 51%, respectively. The cause-specific survival was 96% at both 2 and 5 years. No Radiation Therapy Oncology Group Grade 4 toxicities occurred. Univariate analysis could not identify any patient, tumor, or treatment factors that were statistically significant prognosticators.

Conclusion: RT for SCC of nasal skin achieves excellent outcome, is well tolerated, and should continue to be recommended in the management of this disease.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / radiotherapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nose Neoplasms / mortality
  • Nose Neoplasms / radiotherapy*
  • Ontario / epidemiology
  • Radiotherapy Dosage
  • Skin Neoplasms / mortality
  • Skin Neoplasms / radiotherapy*
  • Survival Rate
  • Treatment Outcome