Comparison of imiquimod 5% cream versus radiotherapy as treatment for eyelid basal cell carcinoma

Background To compare the efficacy, cosmesis and tolerance of two non-surgical treatments—imiquimod (IMQ) 5% cream and radiotherapy (RT)—to combat periocular nodular basal cell carcinoma (BCC). Methods Twenty-seven patients with clinical and histopathological diagnosis of nodular BCC on the eyelid were included and randomly selected: 15 patients were treated with IMQ 5% cream once daily, 5 days/week for 6 weeks, and 12 patients were treated with RT. Results All tumours showed histopathological remission within 3 months of the treatment, and sustained clinical remission was documented in each patient after 24 months9 follow-up. Treatment tolerability was rated as moderate with IMQ and good with RT. Functional results were better in patients treated with IMQ. Loss of eyelashes was reported for most of the patients treated with RT. Conclusions IMQ and RT therapies are effective for treating eyelid nodular BCCs. Cosmesis and functional results were better with IMQ, while tolerability was higher with RT.