Would you recommend large-field radiation therapy to treat SCC of the skin with field cancerization (e.g., entire forearm, scalp) in elderly patients with CLL/immune compromise who have had mixed responses to cemiplimab?

Yes, retrospective data from Australia support large fields using VMAT at a median dose of 47.9 Gy in an average of 23.9 fractions with treatment breaks as needed and using a custom bolus. The photos in the article help clarify what is meant by 'field cancerization.' This phenomenon is termed extens...

Yes. I have done this before, and the patient had a complete response.