How would you treat an unresectable SCC of the skin local recurrence in the base of skull with clinical and radiographic CN involvement?

I usually target gross disease to at least 70 Gy in 35 fractions if my treatment intent is curative. I try to avoid fractional doses >2 Gy around optic nerves and chiasm, so would not typically use 55 Gy in 20 fractions for this reason. HyPERfractionaton, proton beam and concurrent systemic therapy ...

I don't understand the way this question is framed: "around the optic nerves and brainstem." Clinical perineural invasion by cSCC does not typically involve these structures, unless the tumor has invaded into brain directly or traveled via trigem root into brainstem, or unless it is so massive that ...

Considering this patient's history, this treatment has to be considered palliative. Therefore we like to treat them in as rapid a fashion as possible to minimize the amount of time that they must spend receiving treatment. I would treat this patient with SBRT, five fractions of high-dose treatment, ...