Radiation therapy techniques in the treatment of skin cancer: an overview of the current status and outlook

Nonmelanoma skin cancer (NMSC) is a major health concern due to its high incidence rate, its negative impact on the quality of life of patients as well as the associated economic burden to the healthcare system. Surgery is currently the primary treatment offered for skin cancer patients but not applicable or available in all cases. Radiation therapy (RT), with its long successful history in the management of cancer, has shown to be an effective alternative or complementary method in cutaneous oncology. Specifically, for dermatology applications, RT is very often the preferred option due to its favorable cosmetic results, besides the excellent control rate of the tumor. During the last 120 years since the introduction of treatments based on ionizing radiation, several techniques in this area have been developed. Radionuclide brachytherapy, electronic brachytherapy, X-ray therapies with kilovolt (kV) to megavolt (MV) photons and electron beam therapy are the established methods that are currently used on skin cancer patients. The purpose of this article is to overview these techniques and discuss the pros and cons of these methods in dermatology practices. Additionally, a new approach of beta RT of superficial skin tumors is discussed, which may offer exciting features in the management of NMSC.