A radiation oncology approach for using definitive radiotherapy with volumetric modulated arc therapy (VMAT) for skin field cancerisation (SFC)

Patients with long histories of chronic ultraviolet radiation exposure can suffer from skin field cancerisation SFC They can have poor oncological outcomes and quality of life QoL with itch flaking skin and suboptimal cosmesis Current treatments have high rates of treatment failure and non compliance Definitive radiotherapy RT with volumetric modulated arc therapy VMAT has been proposed as a possible treatment modality in this clinical setting This article provides a theoretical background to assist radiation oncologists ROs to implement this technique in their skin cancer practice The article covers the importance of the relationship between the skin physician and the RO how to best understand the patient with SFC patient assessment preparation for RT and RT planning and treatment The article also highlights the difficulty in measuring toxicities with the currently available tools and suggests future research options for affected patients Clinical studies to further refine the use of RT in patients with SFC are warranted