Treatment of morphea-type basal cell carcinomas with radiation therapy

Eight patients received superficial x-ray therapy for morphea-type basal cell carcinomas. Seven lesions did not recur. One recurrence adjacent to an irradiated field was observed; it was considered to be a geographic miss and has led us to include a wider field (10 mm) of normal-appearing skin beyond the clinical perimeter of the tumor when the lesion is ill-defined. The cosmetic results after treatment were poorer than anticipated for this schedule of radiation therapy, based on our extensive experience with other types of basal cell carcinomas. To obtain the best long-term results we believe that, where technically feasible Mohs surgery and conventional surgical excision with histologic verification of free margins are the treatments of choice for morphea-type basal cell carcinomas. However, our experience indicates that morphea-type basal-cell carcinomas can be cured with radiation therapy; therefore, x-rays have a place in the armamentarium of therapeutic modalities for this tumor if surgery is not feasible or if it is refused by the patient.