Initial cosmetic outcome six months after kilovoltage therapy of facial basal cell carcinoma: A Danish national prospective study of 932 patients.

Kilovoltage therapy is a valid treatment option for basal cell carcinomas (BCC), resulting in tumor control rates and cosmetic outcomes comparable to surgery. The aim was to report patient reported satisfaction as well as professional evaluation of cosmesis six months after treatment. From January 2020 to December 2023 a nationwide prospective study was conducted for patients with BCC in the facial region consecutively referred for kilovoltage therapy in five of six Danish cancer centers. Kilovoltage therapy, predominantly 70-100 kV, was delivered as either 51 Gy/17fx or 45 Gy/10fx. A follow-up consultation was performed six months after treatment, where patient satisfaction and professional evaluation were registered. In total 932 patients were included and of these 900 patients (97%) were either satisfied or very satisfied with the cosmetic outcome, which correlated with the professional evaluation (p < 0.001), in which 97% had no or minor skin changes. In univariate analysis, the following factors did not impact patient reported satisfaction with cosmesis: age (p = 0.05), sex (p = 0.2), current smoking (p = 0.2), field size diameter (p = 0.6) or fractionation schedule (p = 0.8). Altogether, 97% were satisfied with the cosmetic result six months after hypofractionated kilovoltage therapy for BCC, which correlated well with the professional objective evaluation.