Definitive Radiotherapy for Basal Cell Carcinoma and Cutaneous Squamous Cell Carcinoma of the Nose

David Gregory Tighe, Bianca Karle, Amelia Hollands, Gavin Gottschalk, Christina Saywell, Terence Poon, Tanya Gilmour, Jillian Wells, Jonathan Stretch, Anne O'Neill, Nina Wines, Michael Li, Andrea Jopp-McKay, Gerald Blaise Fogarty

Abstract


AIM: This study is a retrospective audit of a single clinician’s treatment of basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) of the nasal skin with definitive radiotherapy (RT). Of those patients that were followed up by the referring dermatologists, local control and late side effects are reported. This study also aims to investigate the referral characteristics over time.

MATERIALS AND METHODS: Medical records were searched for patients with nasal BCCs and cSCCs treated by a single clinician between January 2006 and December 2016 at three sites in Sydney (Mater Hospital, St Vincent’s Hospital, and Macquarie University Hospital). Patient, tumour, and treatment factors were collected. Oncological and cosmetic outcome data was obtained by asking referring dermatologists to complete a questionnaire for their referred patients.

RESULTS: 93 patients were identified. 57% were female, and the median age was 76. There were 94 BCCs and 7 cSCCs with four patients having two or more lesions treated. Outcome data was available for 40 patients, and median duration of follow-up was 41 months. As at September 2018, 3 BCCs (7.5%) recurred locally, with a mean time to recurrence of 19 months. Late side effects were seen in five patients treated for BCCs. The most common late side effect seen was telangiectasia (3). The rate of referral to the clinician started at 20 referrals in the 2006-2009 period and increased to 43 in the 2014-2016 period.

CONCLUSION: This study supports the use of definitive RT in BCC and cSCC of the nose, with minimal late side effects. Referrals increased steadily over the study period.


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