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Journal of the American Academy of Dermatology
Volume 74, n° 2
pages 341-347 (février 2016)
Doi : 10.1016/j.jaad.2015.09.031
accepted : 12 September 2015
Original Articles

Orthovoltage radiotherapy for nonmelanoma skin cancer (NMSC): Comparison between 2 different schedules

Riccardo Pampena, MD a, Tamara Palmieri, MD b, Athanassios Kyrgidis, MD c, Dafne Ramundo, MD b, Cinzia Iotti, MD b, Aimilios Lallas, MD c, Elvira Moscarella, MD c, Stefania Borsari, MD c, Giuseppe Argenziano, MD d, Caterina Longo, MD, PhD c,
a Dermatology Unit “Daniele Innocenzi” Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Terracina, Italy 
b Radiotherapy Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy 
c Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy 
d Dermatology Unit, Second University of Naples, Naples, Italy 

Reprint requests: Caterina Longo, MD, PhD, Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy.

Radiotherapy is an established treatment for some types of patients with nonmelanoma skin cancer. A hypofractionated schedule has been proposed as a valuable option for elderly disabled patients to minimize the number of hospital visits.


We sought to compare a weekly hypofractionated orthovoltage radiotherapy regimen with a standard daily one for the treatment of nonmelanoma skin cancer.


A retrospective cohort study was performed on 436 tumors. Overall survival, disease-free survival, and cosmetic outcome were measured. Life-table analysis, Kaplan-Meier survival analysis, and multivariate Cox regression model were performed.


The hypofractionated regimen was not associated with increased recurrence rates and mortality, or with a poorer cosmetic outcome, when compared with the daily schedule.


Absence of complete information about acute treatment toxicity and a shorter follow-up time for patients receiving the weekly schedule are limitations of this study.


A weekly hypofractionated regimen of orthovoltage radiotherapy seems to be the most appropriate approach in elderly disabled patients with nonmelanoma skin cancers.

The full text of this article is available in PDF format.

Key words : basal cell carcinoma, keratinocyte carcinoma, radiotherapy, skin cancer, squamous cell carcinoma, therapy

Abbreviations used : BCC, DFS, NMSC, OS, SCC

 Drs Palmieri and Kyrgidis contributed equally to this work.
 Funding sources: None.
 Conflicts of interest: None declared.

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