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Adenoid cystic carcinomas (ACC) and, to a lesser extent, cutaneous squamous cell carcinomas and basal cell carcinomas may exhibit perineural invasion (PNI). A subset of patients have tumours with extensive PNI tracking to the skull base that is incompletely resectable and is treated with definitive radiotherapy (RT). RT may be administered with intensity-modulated RT or proton RT. Patients with ACC may also be considered for neutron RT, although the number of available neutron facilities is limited. A substantial proportion of patients with incompletely resectable ACCs and cutaneous carcinomas may be cured with definitive RT. Proton RT provides a more conformal dose distribution compared with other modalities and is likely associated with a lower risk of complications.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846408/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846408/
Definitive radiotherapy for skin and Adenoid Cystic Carcinoma with Perineural invasion
Adenoid cystic carcinomas (ACC) and, to a lesser extent, cutaneous squamous cell carcinomas and basal cell carcinomas may exhibit perineural invasion (PNI). A subset of patients have tumours with extensive PNI tracking to the skull base that is incompletely resectable and is treated with definitive radiotherapy (RT).
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