Radiotherapy is useful in the elderly as it does not involve the risks of anaesthesia. It is particular useful in difficult sites - nose, eye, ears where extensive flaps would be required in order to achieve wound closure. The margins of the lesion are not critical. Increased fractionation produces better cosmetic results but makes treatment prolonged and expensive. There is the risk of radiation necrosis of the skin.
Treatment can be difficult and the results less assured than after primary therapy.
Less than 1 in 200 BCCs metastasize. Recent papers Lear J T, Smith A G. Basal cell carcinoma. The treatment of basal cell carcinoma.