A Memo from our MSAC: SRT

Members of the GSA’s Medical and Scientific Advisory Committee (MSAC) have collaborated to author a statement on the use of superficial radiation therapy (SRT) as a treatment option for basal cell carcinoma(s) (BCCs) in people with Gorlin syndrome. It is important to share this critical information with your healthcare provider(s).

Memo:

Use of Superficial Radiation Therapy in Individuals with Gorlin Syndrome

From:  Gorlin Syndrome Alliance Medical and Scientific Advisory Committee, Dr. Elena Hawryluk, Dr. Elizabeth Billingsley, Dr. Ervin Epstein, Dr. Joyce Teng

Date: January 12, 2026

Superficial radiation therapy (SRT) is contraindicated in the treatment of basal cell carcinomas (BCCs) in patients with Gorlin syndrome (also known as basal cell nevus syndrome, or BCNS/BCCNS).

Use of SRT in this population carries risk of increased radiation-induced basal cell carcinomas, often arising within the treatment field and frequently more aggressive or numerous than the primary lesions.

Given this risk, SRT should not be used as a treatment modality for BCCs in Gorlin syndrome patients. Providers are encouraged to consider alternative, non-radiation-based treatments, including surgical excision, Mohs micrographic surgery, topical therapies, or systemic options such as hedgehog pathway inhibitors, as clinically appropriate.

Sources:

Cahn, Brian A. et al. Clinical practice guidelines for the management of basal cell carcinoma in Gorlin syndrome, Journal of the American Academy of Dermatology, Volume 0, Issue 0

Verkouteren BJA, et al.  A guideline for the clinical management of basal cell naevus syndrome (Gorlin–Goltz syndrome).  Br J Dermatol. 2022 Feb;186(2):215-226. 

Likhacheva A et al. Definitive and Postoperative Radiation Therapy for Basal and Squamous Cell Cancers of the Skin: Executive Summary of an American Society for Radiation Oncology Clinical Practice Guideline. Pract Radiat Oncol. 2020 Jan-Feb;10(1):8-20.