What dose-fractionation would you recommend using for a locally advanced, ulcerated squamous cell carcinoma resulting in a non-healing wound in the setting of multiple prior surgeries, flap reconstruction, and baseline immunosuppression?

I have encountered a few similar cases of ulcerated tumors, mostly advanced skin cancers. If non-resectable, full-dose standard chemo-RT; if successful in eradicating the tumor, will result in healing of the wound over time.

My enthusiasm for irradiating the patient would be in the low zeros. If backed into the unsavory position of treating, I’d give 70 Gy/35 fractions.