Superficial radiation therapy in dermatology: A historical perspective

Background Nonmelanoma skin cancers (NMSCs), such as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are the most commonly diagnosed type of cancer in the United States, and the incidence of NMSC is increasing. Though surgical excision and Mohs micrographic surgery remain definitive treatments for NMSC, the majority of affected patients are advanced in age and may have relative contraindications to surgery or preferences against it. As such, there is growing value in exploring less‐invasive alternative techniques, such as superficial radiation therapy (SRT). Historically, in the decades following its inception just over a century ago, the field of SRT experienced a boom of innovations that provided the basis for treatment modalities used by dermatologists today. Aims This paper outlines the history and evolution of SRT in dermatology and discusses SRT's modern role as an alternative to surgical management of NMSC in select patients. Conclusion Although a combination of aging equipment and shifts in interest toward surgical methods diminished the prominence of radiation therapy (RT) in the late 20th century, newer iterations of SRT technology have drawn renewed interest as a nonsurgical extremely effective treatment for NMSC. A brief comparison of key clinical and practical factors indicates that SRT is the optimal choice of RT technique for the definitive management of select NMSCs in patients.