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Radiation therapy (RT) is an efficacious nonsurgical option for the treatment of non-melanoma skin cancer (NMSC). We evaluated the role of RT in elderly patients with facial NMSC.

Thirty-seven patients aged ≥80 years with pathologically confirmed NMSC who received RT on the face between December 2020 and January 2022 were reviewed. Treatment volumes were drawn to include the primary skin lesion with a 1-cm margin around the surface and a 4 mm depth. The patients were treated with intensity-modulated RT, and the RT dose was 55 Gy with 2.75 Gy per fraction. Treatment completion, tumor response, and side effects were assessed to determine their association with age.

The median age at the time of treatment was 87 years (range, 80–100 years). The most common tumor locations on the face were the cheek (n=11) and nose (n=11), followed by the lip (n=4). Histological examination revealed basal cell carcinoma in 18 patients and squamous cell carcinoma in 13. Thirty-one patients received RT as a curative aim and six as a palliative aim. All patients, except one, completed the planned course of RT. After curative intended RT, 22 patients showed a complete response (CR), and 9 had a partial response (PR). Therapeutic response was observed in two patients with CR and four with PR after palliative treatment. Grade 3 or higher skin toxicity was not observed during treatment or until the last follow-up.

Prolonged life expectancy increases the incidence of cancer in older patients. RT could be used safely and effectively in patients aged ≥80 years with facial NMSC, regardless of curative or palliative treatment.