Radiotherapy to the Primary in Keratinocyte and Merkel Cell Cancers and to Skin Metastases

With non-melanoma skin cancer (NMSC) as the most frequently occurring cancer worldwide, we discuss the important role of radiotherapy (RT) in managing patients with NMSC. RT utilises high-energy photons or particles to treat cancer and is an effective and versatile non-surgical treatment option. This is especially the case in patients where surgery may not be a viable option or considered less than optimal (e.g., due to cosmetic and/or functional outcome). With elderly and unwell patients, short course hypofractionated RT is particularly appropriate where surgery is not an option. In patients with unfavourable pathology (e.g., inadequate excision margin) post-operative RT can decrease the risk of developing recurrence in the surgical site. Palliative RT to sites of symptomatic metastases often improves a patient’s quality of life. As with any modality RT has advantages and disadvantages which are important for clinicians to appreciate and understand and be able to discuss with their patients.