Comparison of Different Time-Dose-Fractionation (TDF) Schedules for Management of Nonmelanoma Skin Cancer
Tumor Characteristics Dose Fractionation TDF
MGH
<1 cm tumor; debilitated patient 20–24 Gy in 1 fraction
<2 cm tumor 45 Gy in 5–9 fractions 122—131
2–4 cm or cosmetic concerns 52 Gy in 13 fractions 125
>4 cm tumor 60 Gy in 20 fractions 123
  64 Gy in 25 fractions 116
MDACC
≤1 cm; elderly patient 40 Gy in 8 fractions 125
>1–2 cm in elderly or ≤2 cm in young patient 50 Gy in 15–20 fractions 108–127
Large fields needing good cosmesis 60 Gy in 30 fractions 115
Large, infiltrating tumors 64 to 66 Gy in 32–33 fractions 122–126
 
University of Florida
Large, untreated + bone/cartilage invasion or large, recurrent 65 Gy in 35 fractions 115
Large, untreated + minimal or suspected bone/cartilage invasion 60 Gy in 34 fractions 112
Moderate-to-large inner canthus, eyelid, nasal, pinna (20–30 cm2) 55 Gy in 30 fractions 99
Small, thin (<1.5 cm) eye, nose, ear (10 cm2) 50 Gy in 20 fractions 108
Moderate or postoperative cut-through on free skin 45 Gy in 15 fractions 107
Small (1 cm) on free skin 40 Gy in 10 fractions 111
  30 Gy in 5 fractions 103
Cosmesis not important 40 Gy in 10 fractions 111
  30 Gy in 5 fractions 89
  20 Gy in 1 fractions  
MGH, Massachusetts General Hospital; MDACC, M.D. Anderson Cancer Center.
aMegavoltage.
bOrthovoltage doses. For megavoltage, prescribe dose to D90% or add 10% to total dose and prescribe to D