Radiotherapy alone for clinical T4 XXXX of the @entity135 with surgery reserved for salvage.

@entity1 @entity135 @entity1489 @entity189 @entity3
PURPOSE: To evaluate the outcomes of definitive radiotherapy in the treatment of clinical stage T4 cutaneous @entity189 of the @entity135 . @entity1 AND METHODS: Between October 1964 and September 1997, 85 @entity1 with 88 biopsy-proven clinical AJCC stage T4 @entity189 of the skin of the @entity135 received radiotherapy with curative intent. A total of 43 lesions were previously untreated, and 45 were recurrent after other treatment modalities. Histologic types of @entity189 included squamous cell (37 lesions), basal cell (41 lesions), and metatypical basal (basosquamous) cell (10 lesions). Minimum follow-up was 2 years. The product-limit method was used to determine the rates of disease control, severe late complications, and survival. Multivariate analyses included histology, previous treatment, involvement of bone or nerve, number of structures invaded, node stage, external beam dose, and overall treatment time. RESULTS: At 5 years, the rates of local control after radiotherapy and ultimate local control after salvage surgery were 53% and 90%, respectively. Local control rates were better for @entity1 having previously untreated lesions (P =.05). Regional and ultimate regional control rates were 93% and 100%, respectively, and were better for previously untreated lesions (P <.01), basal cell histology or its metatypical variant (P =.04), and absence of bone invasion (P =.08). At 5 years, the risk of severe late complications was 17%, the risk of distant @entity3 was 5%, and the overall absolute and cause-specific survival probabilities were 56% and 76%, respectively. CONCLUSION: Radiotherapy alone results in a relatively high probability of cure for selected @entity1 with @entity1489 .
