What dose-fractionation would you recommend for a small basal cell carcinoma of the nasal ala in a patient with poor performance status or transportation difficulties?  

This is a perfect case for high dose limited fractions. I would use 6mV electrons. The smaller the field, the faster you can go. 3 FX per week M-W-F. 350 cGy  to 5250 400 cGy to 4800 500 cGy to 4000 600 cGy to 3600 The final stop point determined by response and reaction. 

This patient appears to be an excellent candidate for HDR brachytherapy. An appropriately selected surface applicator (Leipzig or Valencia) may be advantageous compared to electrons by allowing for homogeneous dose distribution to a small area conformality to an irregular/curved surface shallow...

The NCCN guidelines for indolent skin cancers (basal cell carcinoma and squamous cell carcinoma) list four examples of fractionation schedules for definitive treatment of early stage tumors < 2 cm: 64 Gy in 32 fractions over 6 weeks, 55 Gy in 20 fractions over 4 weeks, 50 Gy in 15 fractions over ...

I agree completely. I have had good success (tumor control and good cosmesis) with 600 cGy x 6 fractions given 2 fractions per week.

I would suggest several caveats to the above answers. Electron distributions are unpredictable, particularly on curved surfaces and in small fields.  The larger margins required would likely be problematic on a nasal ala, and orthovoltage or HDR brachy would be preferred for fields 3 cm or les...