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Contact the study team using the details below to take part. If there are no contact details below please ask your doctor in the first instance.
Prof
Catherine
Harwood
SCCAFTER@cardiff.ac.uk
Prof
Agata
Rembielak
SCCAFTER@cardiff.ac.uk
Ms
Ann
White
SCCAFTER@cardiff.ac.uk
More information about this study, what is involved and how to take part can be found on the study website.
Adjuvant radiotherapy in patients with high-risk primary cutaneous Squamous Cell Carcinoma (a non-melanoma skin cancer) after surgery
This information is provided directly by researchers, and we recognise that it isn't always easy to understand. We are working with researchers to improve the accessibility of this information. In some summaries, you may come across links to external websites. These websites will have more information to help you better understand the study.
Some squamous cell cancers are called ‘high-risk’, meaning that there is a higher chance that they could come back after surgery compared to other skin cancers. Around 3 out of 10 people with high-risk skin cancer may experience their cancer coming back within 3 years of the surgery. Radiotherapy (x-ray treatment) is sometimes given to people with high-risk skin cancer after surgery to try and reduce the chances of the cancer coming back. This is called ‘post-operative’ or ‘adjuvant radiotherapy’. It is given to the area of the skin where the cancer was removed. It works by using X-rays to destroy any cancer cells that might be left behind in that area. However, there is no certainty that radiotherapy does stop high-risk skin cancers from coming back. The alternative to radiotherapy is to start a close clinical follow-up to monitor if the skin cancer shows signs of coming back and to treat it if it does. This study aims to find out whether using radiotherapy in people who have had high-risk squamous cell cancer removed by surgery reduces the chances of their skin cancer coming back, or whether radiotherapy is not necessary and only close clinical follow-up is required. The study will also find out what impact it has on quality of life.
Start dates may differ between countries and research sites. The research team are responsible for keeping the information up-to-date.
The recruitment start and end dates are as follows:
You can take part if:
Current inclusion criteria as of 18/02/2026:
1. High-risk primary cSCC (T2b/T3 by BWH staging criteria) excised with histologically clear peripheral and deep margins (≥1 mm by RCPath criteria*). Surgical excision margins should be consistent with BAD guidelines (peripheral and deep) and will be recorded.
2. Time since excision surgery < 3 months (< 4 months acceptable only if necessary)
3. ECOG performance status of 0, 1, 2, or 3 at enrolment (Appendix 1)
4. Aged 18 years or older at time of consent
5. Fit for ART and able to attend radiotherapy outpatient appointments
6. Life expectancy >6 months
7. Informed Consent obtained** which must be prior to any mandatory study-specific procedures, sampling, and analyses
*For SCC on the scalp, a deep histological margin of 0.8 mm - <1 mm is eligible if the deep margin of excision was confirmed to have resected either galea or galea and periosteum or galea, periosteum and bone; the galea is not infiltrated by tumour; the peripheral histological margins are 1mm or greater; the SSMDT assesses that surgi
You may not be able to take part if:
1. Any current clinicopathological evidence of loco-regional recurrence of the index tumour2. Previous (within 3 years) or current non-index primary cSCC in skin drained by the same lymph node basin3. cSCC on anatomical sites which interfere with suitability for ART (such as vermilion lip, eyelids, breast, anogenital area)4. Patients with evidence of regional or distant disease at time of primary cSCC diagnosis5. Previous radiotherapy in the same area6. Patients with reproductive potential who are not willing to use contraception for the duration from trial consent until the last dose of radiotherapy if they are randomised to the ART arm7. Unable to lie still unattended for the duration of ART (estimated to be around 5 minutes)8. Participation in another interventional clinical study that may affect the recurrence of cSCC (primary endpoint)9. History of another malignancy where metastasis could cause diagnostic uncertainty or patients receiving active systemic anti-cancer treatment (excluding hormonal treatment for prostate or breast cancer) or radiotherapy
Below are the locations for where you can take part in the trial. Please note that not all sites may be open.
Prof
Catherine
Harwood
SCCAFTER@cardiff.ac.uk
Ms
Ann
White
SCCAFTER@cardiff.ac.uk
Prof
Agata
Rembielak
SCCAFTER@cardiff.ac.uk
More information about this study, what is involved and how to take part can be found on the study website.
The study is sponsored by Cardiff University and funded by National Institute for Health and Care Research.
Your feedback is important to us. It will help us improve the quality of the study information on this site. Please answer both questions.
Or CPMS: 62841
You can print or share the study information with your GP/healthcare provider or contact the research team directly.
