Hypofractionated radiotherapy in older patients with non-melanoma skin cancer: Less is better

Abstract

Radiotherapy is a non-surgical option for patients with non-melanoma skin cancer. Lesions in middle-aged to older patients with good performance status are typically prescribed 4–5 weeks of outpatient weekday treatment. Daily radiotherapy fraction sizes of 2–3 Gy are recommended to decrease the late cutaneous consequences such as in-field hypopigmentation and telangiectasia. In elderly, often unwell patients, these concerns are less of an issue and larger fraction sizes (5–7 Gy), referred to as hypofractionation, can be delivered over a shorter time yet still achieve excellent in-field control and improve a patient's quality of life and avoid the need for surgery. The three case studies presented illustrate this approach along with a review of the evidence to support this.

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