Table 2.
Favored radiotherapy techniques for management of periocular cutaneous malignancies.
| Favored radiation techniques | Basal cell carcinoma | Squamous cell carcinoma | Sebaceous cell carcinoma | Melanoma* | Merkel cell carcinoma |
|---|---|---|---|---|---|
| Electrons with eye shield | Yes | Yes | Yes | – | Yes |
| IMRT | Yes | Yes | Yes | – | Yes |
| IMPT | Yes | Yes | Yes | – | Yes |
| 3DCRT | – | – | – | – | – |
| ENI | – | Consider for T3/T4 | – | – | Consider if no SLNB or if cN0 and T3/4 or LVSI |
Surgical resection remains the standard for all tumor types. Radiation can be considered for tumors that are unresectable or to spare the globe or other morbidity.
*As a generally radioresistant tumor, radiation should not be routinely considered off clinical trial in the definitive treatment of melanoma.
IMRT, intensity modulated radiation therapy; IMPT, intensity modulated proton therapy; 3DCRT, 3-dimensional conformal radiotherapy; ENI, elective nodal irradiation; SLNB, sentinel lymph node biopsy; LVSI, lymphovascular space invasion.