B. Yau, L. Spelman , G. Fogarty , D. Christie ,A. Kaminski3, C. Baker M. Supranowicz1, R. Sinclair1
Advances in radiation therapy in the last few decades have allowed progressively more accurate and even application of radiotherapy to bodily areas. Volumetric modulated arc therapy (VMAT) is the latest iteration of highly conformal, highly modulated radiotherapy. The improved accuracy and efﬁciency with radiation dose delivery results in reduced radiation spill-over and damage to surrounding tissue, therefore resulting in reduced side effects of radia- tion dermatitis including scarring, telangiectasia and skin changes. With the advent of VMAT and its contemporary techniques, there is an increasing role of radiotherapy in the treatment of extensive skin ﬁeld cancerisation (ESFC). EFSC describes areas of solar damage to skin areas with actinic keratoses, photo-ageing, and skin cancers. ESFC should be treated to alleviate symptoms and halt progres- sion of lesions toward invasive disease. With appropriate patient selection VMAT therapy may be the preferred option of patients with high pre-cancerous lesion load who are weary of surgery or who have failed multiple topical ﬁeld therapies such as 5-ﬂuorouracil (5-FU), Imiquimod, Photodynamic Therapy (PDT) or ingenol mebutate. We seek to demonstrate the safety, efﬁcacy and clinical out- comes in patients undergoing wide-ﬁeld radiation therapy for ESFC and present the 24-month post-treatment safety, efﬁcacy and treatment outcome data.