Reirradiation of Skin Tumors

Radiotherapy Department, North Lisbon Hospital Centre, EPE, Lisbon, Portugal.

Corresponding Author: Virginia Mareco, Radiotherapy Department, North Lisbon Hospital Centre, EPE, Lisbon, Portugal. 
Tel: (+351) 217 805 312; E-Mail: [email protected]

Received Date: 18 Feb 2016   
Accepted Date: 29 Feb 2016   
Published Date: 09 Mar 2016

Copyright © 2016 Virginia M

Citation: Virginia M. (2016). Reirradiation of Skin Tumors. Mathews J Cancer Sci. 1(1): 003.

ABSTRACT

With the increase of life expectancy, there are more cases of local recurrence or in-field secondary cutaneous tumor in previously irradiated skin cancers. In most cases, due to the radiation-induced fibrosis and comorbidities associated with old age, patients have no indication for surgery or systemic treatments (e.g., chemotherapy, cetuximab). Therefore, reirradiation is the option available to try the local control of the cutaneous tumor, and consequently improve the survival. However, there are very few and heterogeneous pre-clinical studies described in literature, and the clinical reports that exist are small and retrospective revisions. This paper is a mini-review of these basic and clinical reports, and other analyses. Irradiation with curative intent is possible, but it must be aware of a decrease in tissue tolerance from previous radiation therapy, that may improve with the increased time between the two irradiations. It should also be take into account the risk-benefit, the comorbidities, the total dose, the fractionations, the irradiated volume, and the dose previously received by the organs at risk. This subject may justify a clinical trial.

KEYWORDS

Skin Cancer; Cutaneous Tumor; Reirradiation; Retreatment; Tolerance; Local Recurrence; Radiation Therapy.

ABBREVIATIONS

BED: Biologically Effective Dose;
BT: Brachytherapy;
EQD2: Biological equivalent dose in 2 Gy fractions;
Gy3: Biologically effective dose assuming an α/β of 3 Gy (dose for late reacting tissues);
IMRT: Intensity-modulated RT;
RT: Radiation Therapy;
SRT: Stereotactic RT.