Indications and Outcomes of Radiation Therapy for Skin Cancer of the Head and Neck

Although BCC and SCC of the skin are common, they account for less than 0.1% of patient deaths caused by cancer. 2 Characteristically, skin cancer develops on sun-exposed areas of lighter-skinned individuals, with most lesions occurring on the head and neck. For skin cancer of the head and neck the treatment options include surgery, radiation therapy, and in some instances a combination of both. Management decisions are guided by the extent of tumor, anatomic site, previous treatments, and the general medical condition of the patient. Cancer of the skin may be removed by conventional resection, Mohs’ micrographic surgery, electrodesiccation, or curettage. Surgical resection of skin cancer is an expedient treatment that offers the advantage of pathologic assessment of the margins. Surgical resection usually achieves excellent local control rates of 90% to 95%. Higher risk for recurrence is correlated with larger tumor size, deep infiltration, poor histologic differentiation, location (ear, lip, and embryonic fusion zones), perineural invasion, recurrent cancer, and immunosuppression. 3–6 Radiation therapy repre