Radiation Therapy in Basal Cell Carcinoma

  • Dirk VordermarkEmail author
Living reference work entry


Surgery is the standard treatment of basal cell carcinoma and produces cure rates of 90–98%. Radiotherapy is an alternative in patients with contraindications to surgery (e.g., related to age or comorbidities) and in locally advanced basal cell carcinomas. Radiotherapy is delivered via electron or orthovoltage techniques and achieves cure rates of 83–95%. The choice of radiotherapy technique must consider the expected extent of the lesion and the characteristics of the chosen beam energy, especially surface and depth dose distribution. Typical dose regimens for electron radiotherapy are normofractionated or moderately hypofractionated while extremely hypofractionated concepts are available for the most elderly and frail patients.


Basal cell carcinoma Electrons Radiotherapy 


  1. Abramson AK, Krasny MJ, Goldman GD. Tangential shave removal of basal cell carcinoma. Dermatol Surg. 2013;39(3Pt1):387–92.CrossRefGoogle Scholar
  2. Avril MF, Auperin A, Margulis A, Gerbaulet A, Duvillard P, Benhamou E, Guillaume JC, Chalon R, Petit JY, Sancho-Garnier H, Prade M, Bouzy J, Chassagne D. Basal cell carcinoma of the face: surgery or radiotherapy? Results of a randomized study. Br J Cancer. 1997;76(1):100–6.CrossRefGoogle Scholar
  3. German Centre for Cancer Registry Data. In: Robert Koch Institute, the Association of Population-based Cancer Registries in Germany, editors. Cancer in Germany 2011/2012. 10th ed. Berlin: Robert Koch Institute; 2016.Google Scholar
  4. Chahal HS, Rieger KE, Sarin KY. Incidence ratio of basal cell carcinoma to squamous cell carcinoma equalizes with age. J Am Acad Dermatol. 2017;76(2):353–4.CrossRefGoogle Scholar
  5. Cho M, Gordon L, Rembielak A, Woo TC. Utility of radiotherapy for treatment of basal cell carcinoma: a review. Br J Dermatol. 2014;171(5):968–73.CrossRefGoogle Scholar
  6. Gunaratne DA, Veness MJ. Efficacy of hypofractionated radiotherapy in patients with non-melanoma skin cancer: results of a systematic review. J Med Imaging Radiat Oncol. 2018; Epub ahead of print.CrossRefGoogle Scholar
  7. Hall VL, Leppard BJ, McGill J, Kesseler ME, White JE, Goodwin P. Treatment of basal-cell carcinoma: comparison of radiotherapy and cryotherapy. Clin Radiol. 1986;37(1):33–4.CrossRefGoogle Scholar
  8. Huynh NT, Veness MJ. Basal cell carcinoma of the lip treated with radiotherapy. Australas J Dermatol. 2002;43(1):15–9.CrossRefGoogle Scholar
  9. Khan L, Choo R, Breen D, Assaad D, Fialkov J, Antonyshyn O, McKenzie D, Woo T, Zhang L, Barnes E. Recommendations for CTV margins in radiotherapy planning for non melanoma skin cancer. Radiother Oncol. 2012;104(2):263–6.CrossRefGoogle Scholar
  10. Kossard S, Epstein EM, Cerio R, Yu LL, Weedon D. In: LeBoit PE, Burg G, Weedon D, Sarasin A, editors. WHO classification of tumors, Pathology and genetics of skin tumors. 1st ed. Lyon: IARC-Press; 2006.Google Scholar
  11. Krema H, Herrmann E, Albert-Green A, Payne D, Laperriere N, Chung C. Orthovoltage radiotherapy in the management of medial canthal basal cell carcinoma. Br J Ophthalmol. 2013;97(6):730–4.CrossRefGoogle Scholar
  12. Kricker A, Weber M, Sitas F, Banks E, Rahman B, Goumas C, Kabir A, Hodgkinson VS, van Kemenade CH, Waterboer T, Armstrong BK. Early life UV and risk of basal and squamous cell carcinoma in New South Wales, Australia. Photochem Photobiol. 2017;93(6):1483–91.CrossRefGoogle Scholar
  13. NCCN Clinical Practice Guidelines in Oncology: Basal Cell Skin Cancer. Version I.2018 – September 18, 2017.Google Scholar
  14. Olschewski T, Bajor K, Lang B, Lang E, Seegenschmiedt MH. Radiotherapy of basal cell carcinoma of the face and head: importance of low dose per fraction on long-term outcome. J Dtsch Dermatol Ges. 2006;4(2):124–30.CrossRefGoogle Scholar
  15. Ostheimer C, Hübsch P, Janich M, Gerlach R, Vordermark D. Dosimetric comparison of intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) in total scalp irradiation: a single institutional experience. Radiat Oncol J. 2016;34(4):313–21.CrossRefGoogle Scholar
  16. Rubin AI, Chen EH, Ratner D. Basal-cell carcinoma. N Engl J Med. 2005;353(21):2262–9.CrossRefGoogle Scholar
  17. Sekulic A, Migden MR, Oro AE, Dirix L, Lewis KD, Hainsworth JD, Solomon JA, Yoo S, Arron ST, Friedlander PA, Marmur E, Rudin CM, Chang AL, Low JA, Mackey HM, Yauch RL, Graham RA, Reddy JC, Hauschild A. Efficacy and safety of vismodegib in advanced basal-cell carcinoma. N Engl J Med. 2012;366(23):2171–9.CrossRefGoogle Scholar
  18. Swanson EL, Amdur RJ, Mendenhall WM, Morris CG, Kirwan JM, Flowers F. Radiotherapy for basal cell carcinoma of the medial canthus region. Laryngoscope. 2009;119(12):2366–8.CrossRefGoogle Scholar
  19. van Loo E, Mosterd K, Krekels GA, Roozeboom MH, Ostertag JU, Dirksen CD, Steijlen PM, Neumann HA, Nelemans PJ, Kelleners-Smeets NW. Surgical excision versus Mohs’ micrographic surgery for basal cell carcinoma of the face: a randomised clinical trial with 10 year follow-up. Eur J Cancer. 2014;50(17):3011–20.CrossRefGoogle Scholar
  20. Work Group, Bichakjian C, Armstrong A, Baum C, Bordeaux JS, Brown M, Busam KJ, Eisen DB, Iyengar V, Lober C, Margolis DJ, Messina J, Miller A, Miller S, Mostow E, Mowad C, Nehal K, Schmitt-Burr K, Sekulic A, Storrs P, Teng J, Yu S, Huang C, Boyer K, Smith Begolka W, Alam M. Guidelines of care for the management of basal cell carcinoma. J Am Acad Dermatol. 2018;78(3):540–59.Google Scholar
  21. Zagrodnik B, Kempf W, Seifert B, Müller B, Burg G, Urosevic M, Dummer R. Superficial radiotherapy for patients with basal cell carcinoma: recurrence rates, histologic subtypes, and expression of p53 and Bcl-2. Cancer. 2003;98(12):2708–14.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Radiation OncologyMartin Luther University Halle-WittenbergHalle (Saale)Germany

Personalised recommendations