What dose-fractionation would you recommend for post-operative radiation therapy for an excised cutaneous squamous cell carcinoma of the foot with a skin graft?

This is a tricky question. There are several factors I would like to know to recommend post operative RT: 1) What was the location of the lesion, size and histological grade? 2) Any high risk factors such as LVI? 3) I presume the tumor was resected; what is the Path status of the margins? Close, pos...

60 Gy/30 fractions. This situation sounds high risk for complications, and therefore I would not hypofractionate.

I would treat only for a positive margin; and no more surgery is possible short of an amputation, because of the risk of a complication requiring an amputation. 60 Gy/30 fractions. I usually go higher, but not for the foot or pretibial.