title: 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.
authors.affiliation: Department of Radiation Oncology, Westmead Cancer Care Centre, Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Veness
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D004428:Ear Neoplasms / Q000532:radiotherapy*; D005260:Female; D006225:Hand; D006801:Humans; D008297:Male; D012535:Scalp; D012878:Skin Neoplasms / Q000532:radiotherapy*
keywords: hypofractionation; non-melanoma skin cancer; radiotherapy