PowerPoint Presentation

XRT in skin cancers – special clinical situations

• Perineural invasion (PNI) – TNM 8 th Ed. increased risk of regional and distant mets 2% excised BCCs and 5% excised SCCs no universally accepted guidelines

adjuvant XRT in completely excised lesions with PNI in large caliber nerves (≥ 0.1) XRT to treat neural pathways, consider CNS late toxicity

• Perivascular invasion (PVI)

less evidence, not included in TNM 8 th Ed.

• Immunocompromised patients

no recommendation for prophylactic lymph nodes irradiation concurrent systemic treatment / methotrexate