The Potential Role of Radiation Therapy in Bowens Disease: A Review of the Current Literature

Zygogianni      Anna; Kouvaris      John; Tolia      Maria; Kyrgias      George; Beli      Ivelina; Kantzou      Ioanna; Soulimioti      Georgia; Kouloulias      Vassilis

Abstract

Background: Bowens disease is a form of squamous cell carcinoma in situ that can be transformed into invasive squamous cell carcinoma and should be treated according to its anatomical position. The aim of this article is to offer an overview of treatment options with an emphasis on radiation therapy in the treatment of Bowens disease. Methods and Materials: We performed overview of the literature based on database searches in PubMed/MEDLINE and we included articles till December 2010. Only papers published in English were included. Results: There was no standard fractionation regimen: some physicians prescribed high doses, such as the ones of invasive skin cancer, whereas others prescribed lower doses because of the noninvasive nature of the disease, the sensitive anatomic location (e.g., extremity) and the large treatment area. Various studies demonstrate high rates of tumor control with minimal morbidity following definitive radiation therapy in the treatment of Bowens Disease. Through a multidisciplinary assessment, the treatment of Bowens disease can be individualized to optimize patient care. Conclusions: Radiation therapy is an effective treatment option for Bowens disease of the skin. Local recurrences seem to be equally low in patients treated with high- and low-dose regimens. Radiotherapy preserves normal tissues ensuring a superior esthetic and functional outcome.

Keywords: Bowen's disease, toxicity, review, radiotherapy, cosmesis, Photodynamic therapy, Methyl aminolevulinate, non melanoma skin cancer, Cryotherapy, Surgical excision