Cutaneous squamous cell carcinoma represents the second most common nonmelanoma skin cancer, with increasing incidence. Radiation therapy has an important role in the management of these patients either in a curative, adjuvant or palliative setting.

We present the case of an 88-year-old woman with an extensive periorbital squamous cell carcinoma who did not have physical conditions to make an appropriate radiation therapy treatment with adequate positioning. For that reason, an unusual approach was taken, treating the patient in the hospital stretcher with a direct electron beam of 6 MeV and a dose of 30 Gy/5 Fr. The patient achieved a complete clinical response within 4 months. This case shows that although we are facing a continuous evolution of linear accelerators, special radiotherapy techniques and increasingly effective immobilization systems, in some cases we need to rethink our strategy and use older techniques to be able to treat the patient.