Utility of radiotherapy for treatment of basal cell carcinoma: a review

Abstract

Radiotherapy is an available treatment for management of basal cell carcinoma (BCC). This study aims to analyse the published literature about radiotherapy in treatment of BCC. A focus of this study will be to compare the dosing regimens adopted in these studies. A search of the Medline database was conducted from 1984 to August 2013. Search terms used were 'basal cell carcinoma', 'radiotherapy', 'epithelial skin cancer' and 'external irradiation'. Fourteen studies on the use of radiotherapy for BCC were included. Seven studies included only cases of BCC, while six studies also included patients treated for squamous cell carcinoma. The overall cure rates ranged from 79·2% to 100%. More than 90% of the patients reported good or excellent aesthetic outcome from radiotherapy (three studies). There was a wide variation in the total dose and dose per fraction of radiotherapy used. Nine studies utilized dosing regimens within the recommended guidelines of the National Comprehensive Cancer Network. There are a limited number of high-quality prospective studies of radiotherapy for BCC. Based on the available evidence, radiotherapy provides a high rate of local control with low rates of complications that are comparable with surgery.

Surgery Versus 5% Imiquimod for Nodular and Superficial Basal Cell Carcinoma: 5-Year Results of the SINS Randomized Controlled Trial

“…We have been unable to identify any further trials comparing topical imiquimod versus other active therapies for the treatment of low risk nodular or superficial BCC, and none with 5 years follow-up. A review has shown that radiotherapy also offers comparable cure rates (Cho et al, 2014) and good cosmetic outcomes, but only two RCTs were included in that review.…”

Efficacy of hypofractionated radiotherapy in patients with non‐melanoma skin cancer: Results of a systematic review

“…Radiotherapy is a highly effective non‐surgical option available to patients with NMSC . NMSC is radioresponsive and most patients treated with definitive RT can expect excellent local control rates exceeding 95% . Most younger patients when recommended RT will be prescribed RT fraction sizes of 2–2.5 Gy delivered on consecutive week days over 4–5 weeks aiming to achieve the best long‐term outcome (cure and cosmesis) .…”

“…6 NMSC is radioresponsive and most patients treated with definitive RT can expect excellent local control rates exceeding 95%. 7 Most younger patients when recommended RT will be prescribed RT fraction sizes of 2-2.5 Gy delivered on consecutive week days over 4-5 weeks aiming to achieve the best long-term outcome (cure and cosmesis). 8 In older patients, the late effects tend to be less of a concern with more consideration placed on decreasing the total duration of treatment and often utilizing daily fraction sizes of 3-4 Gy over 2-3 weeks (40-45 Gy in 10-15 fractions).…”

Adjuvant radiotherapy in management of trichilemmal carcinoma of left nasal alae with positive surgical margins: A case report

“…In this setting, regarding its well-established efficacy in BCC and SCC external beam RT appears to be an appropriate treatment option for such patients. [9,10] To our best information, this is the first report on successful treatment of TLC with RT. We decided to prescribe 50 Gy (2 Gy/fr) in view of the way that it is in the commonly practiced total dose (45-50 Gy) and fractionation (1.8-2 Gy) ranges recommended for any tumor type with microscopically positive margin(s).…”