Superficial and Orthovoltage X-Ray Therapy for Skin Lesions — What It Treats, How Many Sittings, and Whether You Can Get It Here

It is used mainly for non-melanoma skin cancers — basal cell carcinoma and cutaneous squamous cell carcinoma — and for a few benign skin problems such as a keloid scar that keeps coming back after excision. The beam is deliberately weak so that it stops close to the surface, which is exactly what a shallow lesion needs.

Both machines are kilovoltage X-ray tubes. Superficial units run at roughly 50 to 150 kV and deposit most of their dose in the first few millimetres of tissue. Orthovoltage units, sometimes still called deep X-ray therapy, run at roughly 150 to 500 kV and remain useful to a depth of around two centimetres. Below that the dose drops away, which is the whole design intent.

That shallow reach decides who benefits. A thin lesion on the bridge of the nose, the rim of the ear, an eyelid or the lip — sites where surgery would take tissue that is hard to replace — is the classic scenario. So is an older or frail patient for whom the operation and the healing afterwards would be the harder part of the treatment. It is also used to settle a sore, bleeding or fungating skin nodule when the aim is comfort rather than long-term control, and after surgery where the pathology report suggests more treatment to the scar area is advisable.

What it is not for matters just as much. Kilovoltage therapy is not the primary treatment for melanoma. It cannot reach a lymph node or anything sitting deep under the skin. And it is not a shortcut around a diagnosis: a lesion needs a biopsy result before any radiation is planned for it. NCCN guidance lists surgery and radiotherapy as recognised primary options for selected non-melanoma skin cancers, and the choice between them is made lesion by lesion, not by machine.

Your radiotherapy is delivered at an NABH-accredited partner centre; CION Cancer Clinics coordinates your treatment plan, your oncology team and your care throughout.

There is no single number. Courses for skin lesions commonly run from about five sittings across a week to around twenty across four weeks. A single sitting is sometimes used when the aim is to settle bleeding or discomfort. Each sitting takes only a few minutes, and most of the visit is positioning rather than treatment.

Four things pull the number up. A larger lesion needs a bigger field, and a bigger field is usually spread over more sittings so that the skin tolerates it. A site where the cosmetic result matters — the face, especially near the eye or the mouth — is usually treated more slowly for the same reason. Thin skin lying directly over cartilage or bone is treated cautiously, because those tissues absorb proportionally more dose at kilovoltage energies. And a lesion being treated with long-term control in mind is generally given more sittings than one being treated for symptom relief.

Two things pull the number down. Frailty is one: a schedule that means a daily trip for a month can be harder on an eighty-year-old than the radiation itself. Distance is the other, and it is an entirely legitimate thing to raise. If reaching the centre means two buses each way, say so before the schedule is fixed rather than after — shorter schedules exist, and your radiation oncologist can only weigh what they know about.

Ask for the number of sittings in writing at your planning visit, together with the time each visit is likely to take door to door. That single sheet makes it far easier to arrange transport, work leave and a caretaker for the weeks ahead.

Honestly, it is uncommon. Dedicated superficial and orthovoltage units were widely used decades ago, but most Indian centres retired them as they moved to linear accelerators, and many cancer hospitals in Hyderabad do not have one. If you have read about this treatment and gone looking for it, that is why you struggled to find it.

What that does not mean is that you have missed out on something. The clinical job — putting dose into the first centimetre or two of tissue and no further — can usually be done another way. An electron beam from a linear accelerator can be tuned to a chosen depth. A high-dose-rate surface mould, made to sit over a curved site such as the nose or the ear, does the same thing from the outside in. Which of the three a centre offers depends on what equipment it has installed, so it is a question to ask directly rather than to guess at.

CION Cancer Clinics does not own or operate a linear accelerator, a kilovoltage therapy unit or any radiotherapy facility, and CION is not itself NABH-accredited. Radiotherapy and PET-CT are delivered at NABH-accredited partner centres; CION coordinates your treatment plan, your oncology team and your care throughout. That is also why the availability question is one we can answer plainly — there is no machine here we need you to choose.

If you have been told your only option is to travel far for a specific machine, get that checked before you book anything. A short conversation about depth and technique often shows that a nearer centre can deliver what your lesion actually needs.

Kilovoltage skin treatment is generally among the less expensive radiotherapy options, because the planning is simpler and the course is usually short. Scheme cover, though, follows the approved package and the empanelment of the treating hospital — not how old or new the machine is.

Aarogyasri, Ayushman Bharat PM-JAY, CGHS and most cashless insurance policies fund radiotherapy through defined packages at empanelled hospitals. Which package your treatment falls under depends on the diagnosis and the technique named in your plan, so settle that in writing with the hospital insurance desk before the course begins, not after the first sitting. If a scheme card is what makes the treatment possible for your family, say so at the first consultation — the sequence of paperwork is easier to get right at the start.

Every figure anyone quotes you is indicative only, as of August 2026, and it shifts with the centre, the technique, the number of sittings and the site treated. Do not work from a verbal number. Ask for a written estimate that separates consultation, planning, delivery per sitting and review visits, so that two centres can be compared on the same terms rather than on impressions. And count the journeys: for a course spread over several weeks, transport and a companion's time are a real part of the total cost, particularly for an elderly patient travelling in from a district.

If cost is the obstacle, raise it before planning starts. There is often more than one acceptable way to deliver a prescription, and that conversation is far more useful at the beginning than midway through a course.

• Read something about a treatment delivered in a fraction of a second and wondered whether you can have it? FLASH Radiotherapy: What It Is and Whether You Can Get It is the honest answer on where that technique currently stands.
• Told your tumour is too large for a standard field? GRID and Lattice Radiotherapy for Very Large Tumours explains a different approach to bulky disease and where it is used.
• If the problem is not one lesion but skin disease spread across the whole body, Total Skin Electron Beam Therapy for Skin Lymphoma covers the electron-beam technique built for exactly that.
• Facing a bone marrow transplant and told radiation is part of the preparation? Total Body Irradiation Before a Bone Marrow Transplant sets out what that involves.
• For the wider picture — how radiation is planned, delivered and coordinated with NABH-accredited partner centres — see Radiation Therapy at CION Cancer Clinics.

Still unsure which technique your lesion needs? Book a free consultation and a radiation oncologist will go through the report with you, or call 1800 202 8726.