Superficial Radiation Therapy: The Gentle Giant of Nonmelanoma Skin Cancer Treatment

ABSTRACT Background Nonmelanoma skin cancer (NMSC), primarily basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), represents a significant and growing health concern. These cancers, largely attributed to cumulative sun exposure, present unique challenges in treatment due to their prevalence, particularly in cosmetically sensitive areas, and the varied health statuses of affected patients. Traditional treatment modalities, such as surgical excision and Mohs micrographic surgery, while effective, may not be suitable for all individuals, especially the elderly population or those with comorbidities. Superficial radiation therapy (SRT) has emerged as a valuable alternative, offering a noninvasive approach that targets superficial tumors with low‐energy X‐rays. This literature review aims to consolidate current knowledge regarding SRT, focusing on its indication, treatment parameters, efficacy, safety, and patient selection, to provide a comprehensive overview of its role in NMSC management. Methods This literature review compiles data from a wide range of clinical studies, meta‐analyses, and systematic reviews published in peer‐reviewed journals. The search strategy involved utilizing medical databases such as PubMed, MEDLINE, and Wiley, with keywords including “superficial radiation therapy,” “nonmelanoma skin cancer,” “basal cell carcinoma,” “squamous cell carcinoma,” “SRT efficacy,” “SRT side effects,” and “SRT treatment protocols.” Studies were included if they provided relevant data on SRT's efficacy, safety, treatment protocols, and patient selection for NMSC. Emphasis was placed on studies with robust methodologies, including randomized controlled trials, large cohort studies, and meta‐analyses. Data extracted from these studies included tumor control rates, recurrence rates, side effect profiles, treatment protocols, and patient‐reported outcomes. The findings were then summarized to provide a comprehensive overview of SRT's role in NMSC management. Conclusion SRT stands as a highly effective and safe treatment modality for NMSC, particularly for BCC and SCC. This review demonstrates that SRT achieves high tumor control rates with low recurrence, offering a favorable safety profile compared to surgical alternatives. Its noninvasive nature and minimal recovery time make it especially suitable for elderly patients, those with comorbidities, and individuals seeking cosmetic preservation. Standardized treatment protocols, including fractionated dosing, optimize therapeutic outcomes while minimizing side effects. Patient selection, based on tumor characteristics, health status, and personal preferences, is crucial for achieving optimal results. Thus, SRT is a reliable and consistently efficacious treatment option for NMSC, offering a compelling alternative to surgical intervention.