The place of radiation therapy in the treatment of squamous cell carcinoma of the nasal vestibule. A review

Abstract

Radiation therapy and limited resection give equally good results in early squamous cell carcinomas of the nasal vestibule, each producing local control rates of 90% or more. For more extensive disease, primary radiation therapy with surgery reserved for residual or recurrent carcinoma is recommended in view of the significant cosmetic defects which generally follow major resection. Small and superficial lesions can be treated by external beam therapy or interstitial implants. Large or infiltrative lesions are best managed by external beam therapy. Serious late morbidity following irradiation is uncommon and has been reported in fewer than 5% of patients. Regional nodal metastases are diagnosed at the time of first presentation in about 5% of patients and signal a very poor prognosis. However, the data available do not support elective treatment of clinically uninvolved regional nodes. Fewer than 5% of patients manifest late nodal metastases when the primary tumor area remains free of recurrence, and most of these metastases can be controlled by neck dissection and/or irradiation.