Work

High-dose-rate brachytherapy using Leipzig applicators for non-melanoma localized skin cancer

Year: 2020

Type: article

Abstract: Purpose: Technological advances with commercial production of surface applicators allowed high-dose-rate (HDR) afterloading brachytherapy to overpass challenges associated with the delivery of superficial radiation when treating non-melanoma skin cancer (NMSC).We reviewed our single institutional experience using HDR to treat basal (BCC) and squamous cell (SCC) carcinomas. Material and methods:A retrospective review of all patients treated with HDR and Leipzig-style applicators for NMSC at the Radiation Oncology Department, AC Camargo Cancer Center, from March 2013 to December 2018 was performed.Results: Seventy-one patients with 101 lesions (BCCs, 69.3% or n = 70) and median age 80 (range, 51-102) years old were evaluated.The median follow-up was 42.8 (range, 12-82) months.The 3-year and 5-year actuarial local control (LC) rates were 97.9% and 87.2%, respectively.On univariate analysis, treatments with EQD 2 less than 50 Gy (p < 0.001) and dose per fraction smaller than 3 Gy (p < 0.001) were found to be statistically significant predictive factors of a worse outcome.On multivariate analysis, SCC had a worse prognosis over BCC (p = 0.007, HR = 2.3, CI: 1.2-6.6).All patients developed some degree of acute side effects graded 1 to 2. Grade 3 acute side effects were observed in 9 (8.9%) patients.Moreover, severe late side effects (grade 3), hypopigmentation, and telangiectasia were observed in 4 (3.9%)patients.No grade 4 acute or late side effects were seen in this cohort.Conclusions: HDR offers a convenient treatment schedule for patients and is associated with excellent LC.The most effective regimen, in terms of dose and fractionation, to treat superficial NMSC with HDR remains uncertain, but a moderate minimum EQD 2 dose of 50 Gy should be used.

Source: Journal of Contemporary Brachytherapy

DOI: 10.5114/jcb.2020.100376