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February 12, 1982

Treatment of Skin Carcinoma of the Face and Neck-Reply

Author Affiliations

Radiation Oncology Medical Group of Southern California Fountain Valley

JAMA. 1982;247(6):754. doi:10.1001/jama.1982.03320310018015

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In Reply.—  From correspondence received subsequent to the publication of our article on "The Treatment of Cutaneous Malignancies With Irradiation," it appears necessary to stress the point made in the article that proper protraction and selection of a well-filtered, high-quality beam leads to limited or negligible apparent radiation effect in the normal tissues adjacent to the cutaneous malignancies. The importance of protraction and beam quality cannot be too greatly stressed. It is primarily because of this that the long-term sequelae so commonly associated with irradiation of cutaneous malignant neoplasms can be avoided. The experience on which this series of statements is made dates back to patients treated from 1949 with close observation and meticulous follow-up.The choice of more expeditious courses of irradiation, ie, giving a high dose per fraction and the lack of attention to proper filtration of the treatment beam, can lead only to those negative findings referred