Use of Radiotherapy in the Treatment of Non-melanoma Skin Cancer: Experience From a Regional Referral Center

Background Non-melanoma skin cancer is the most common malignancy worldwide. Although surgery remains the treatment of choice in most cases, radiotherapy represents an important alternative in patients who are not candidates for resection, in anatomically complex locations, or as adjuvant therapy. Although radiotherapy has been associated with favorable local control rates in multiple studies, evidence from real-world clinical practice, particularly in heterogeneous cohorts and locally advanced disease, remains limited. The aim of this study was to describe the clinicopathological characteristics, radiotherapy schemes, local outcomes, and toxicity in patients treated at a regional referral center. Methods A retrospective descriptive case series was conducted at a regional referral hospital in Mexico. Patients with histopathologically confirmed non-melanoma skin cancer treated with radiotherapy during 2023 were included. Demographic, tumor-related, treatment, and follow-up variables were analyzed using descriptive statistics. Clinical outcomes, including local failure and toxicity, were assessed based on retrospective clinical documentation without standardized response criteria or validated toxicity scales. Results A total of 18 patients were included, with a mean age of 74.2 years; 66.7% were male. The most frequent histologies were basal cell carcinoma (44.4%) and squamous cell carcinoma (38.9%). Two-thirds of cases corresponded to locally advanced disease (T3-T4). The series was heterogeneous regarding treatment intent and radiotherapy modality. The mean administered dose was 49 Gy in 17 fractions. During a mean follow-up of 7.7 months, 15 patients (83.3%) had no documented local failure during the available follow-up period, while three patients (16.7%) did. Late toxicity was infrequently reported and mainly limited to cutaneous changes, based on retrospective clinical documentation. These findings reflect the clinical course observed during the available follow-up period and should be interpreted within the context of its duration and the retrospective, non-standardized nature of outcome assessment. Conclusion Findings from this case series should be interpreted strictly as descriptive observations derived from routine clinical practice, given the small sample size, clinical heterogeneity, lack of standardized outcome assessment, and limited follow-up duration.