For a patient treated with Mohs surgery for a high risk skin cancer of the head/neck do you post-operatively treat all scars to full dose, including those created at subsequent closure?
I have seen some patients who may undergo large complex closures (sometimes as a separate procedure) for smaller lesions with resulting scars that significantly increase the target volume. Would you treat these secondary scars to lower (or zero) dose?
Answer from: Radiation Oncologist at Academic Institution
There are a few high quality studies of adjuvant radiotherapy to the site of a primary skin cancer that help guide the answer to your question that I am aware of.
Based on first principles, it would seem like the area that the tumor originated, as well as the surrounding area at risk for subclinica...
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Answer from: Radiation Oncologist at Academic Institution
The tumor bed and the surgical approach to achieve tumor resection (op note) guide my target volume - leaving aside any elective volumes that may need attention e.g., nodal cover or nerve pathways cover that am not going to discuss here. If there were additional incisions and/or reconstructive proce...
Answer from: Radiation Oncologist at Academic Institution
I do not irradiate secondary incisions.