A comparison of late cosmetic results following two different radiotherapy techniques for treating basal cell carcinoma.

Fractionated superficial X-ray therapy and gold grain brachytherapy Elastoplast mould (EPM) methods of treating basal cell carcinoma (BCC) on facial skin were compared for long term cosmesis. Thirty patients were traced who had been treated successfully for a BCC on the face more than ten years previously. Late skin and subcutaneous changes were graded. Fifteen had been treated with 116 kV X-rays (32.5 Gy in five fractions on 5 consecutive days, and the remaining 15 with radioactive gold EPMs, delivering a dose of 6000-6500 R with an application lasting 7 days). The late cosmetic result scores of the patients treated by X-rays gave a mean score of 2.13; only three of these patients had a score of less than 2. The mean score for the patients treated with EPMs was 1.47; none had a score greater than 2. The difference is statistically significant (P < 0.01, Wilcoxon rank sum test). The EPM gave much more acceptable late cosmetic results.