High-dose-rate Skin Brachytherapy with Interstitial, Surface, or a Combination of Interstitial and Surface Mold Technique

Overview

Journal J Contemp Brachytherapy

Date 2022 May 2

PMID 35494184

Authors

Serhii Brovchuk

Sang-June Park

Zoia Shepil

Serhii Romanenko

Oleg Vaskevych

Affiliations

Soon will be listed here.

Abstract

Purpose: In order to demonstrate capabilities of brachytherapy in skin cancer treatment, we reviewed clinical outcomes of patients with non-melanoma skin cancer (NMSC) treated with high-dose-rate brachytherapy (HDR-BT) at a single-institution.

Material And Methods: A surface custom mold (SC), interstitial (IS), or a combination of IS and SC applicator (IS + SC) was used for treatment based on depth of tumor invasion. Contoured growth tumor volume plus a 0.5 cm margin for basal cell carcinomas (BCC) and a 1-1.5 cm margin for squamous cell carcinomas (SCC) was considered a target. A prescription dose of 41.6 Gy in 8 fractions was delivered to BCC, and 46.8 Gy in 9 fractions to SCC.

Results: From 2013 to 2018, a total of 751 NMSC patients (534 BCCs and 217 SCCs) were treated with HDR-BT (518 with IS, 225 with SC, and 8 with IS + SC technique). Thirty patients (4%) partially responded to treatment, and 721 patients (96%) had complete responses. Only 3 patients (0.4%) displayed local recurrences. Grade 1, 2, and 3 acute toxicities were observed in 28.0%, 46.7%, and 1.2% of patients, respectively. Grade 1, 2, and 3 late toxicities were observed in 3.3%, 1.3%, and 0.1% of cases. Cosmetic results were excellent in 79.9%, good in 17.8%, fair in 1.7%, and poor in 0.5% of patients.

Conclusions: HDR-BT using SC, IS, or IS + SC is an effective treatment for NMSC with good outcomes and cosmetic results in both BCC and SCC.

Citing Articles

Surface mold brachytherapy for head and neck non-melanoma skin cancer - local control rates and survival: A retrospective analysis.

Esmati E, Abyaneh R, Jaberi R, Naderinasab S, Gholami S, Payandeh M J Contemp Brachytherapy. 2024; 16(5):323-334.

PMID: 39719956 PMC: 11664796. DOI: 10.5114/jcb.2024.144703.

Comparison of image registration methods in patients with non-melanoma skin cancer treated with superficial brachytherapy.

Szlag M, Stankiewicz M, Kellas-Sleczka S, Stapor-Fudzinska M, Cholewka A, Pruefer A Phys Imaging Radiat Oncol. 2024; 31:100631.

PMID: 39262679 PMC: 11387206. DOI: 10.1016/j.phro.2024.100631.

Multilayer intensity modulated contact interventional radiotherapy (brachytherapy): Stretching the therapeutic window in skin cancer.

Fionda B, Placidi E, Rosa E, Lancellotta V, Stimato G, De Angeli M J Contemp Brachytherapy. 2023; 15(3):220-223.

PMID: 37425199 PMC: 10324588. DOI: 10.5114/jcb.2023.127837.

ORIFICE (Interventional Radiotherapy for Face Aesthetic Preservation) Study: Results of Interdisciplinary Assessment of Interstitial Interventional Radiotherapy (Brachytherapy) for Periorificial Face Cancer.

Tagliaferri L, Giarrizzo I, Fionda B, Rigante M, Pagliara M, Casa C J Pers Med. 2022; 12(7).

PMID: 35887535 PMC: 9316930. DOI: 10.3390/jpm12071038.

References

Tormo A, Celada F, Rodriguez S, Botella R, Ballesta A, Kasper M . Non-melanoma skin cancer treated with HDR Valencia applicator: clinical outcomes. J Contemp Brachytherapy. 2014; 6(2):167-72. PMC: 4105643. DOI: 10.5114/jcb.2014.43247. View

Ouhib Z, Kasper M, Calatayud J, Rodriguez S, Bhatnagar A, Pai S . Aspects of dosimetry and clinical practice of skin brachytherapy: The American Brachytherapy Society working group report. Brachytherapy. 2015; 14(6):840-58. DOI: 10.1016/j.brachy.2015.06.005. View

Jones B, Dale R . Mathematical models of tumour and normal tissue response. Acta Oncol. 1999; 38(7):883-93. DOI: 10.1080/028418699432572. View

Pellizzon A, Fogaroli R, Chen M, Maia P, Gondim G, Guedes D . High-dose-rate brachytherapy using Leipzig applicators for non-melanoma localized skin cancer. J Contemp Brachytherapy. 2020; 12(5):435-440. PMC: 7701921. DOI: 10.5114/jcb.2020.100376. View

Jones B, Dale R, Deehan C, Hopkins K, Morgan D . The role of biologically effective dose (BED) in clinical oncology. Clin Oncol (R Coll Radiol). 2001; 13(2):71-81. DOI: 10.1053/clon.2001.9221. View

Skowronek J . Brachytherapy in the treatment of skin cancer: an overview. Postepy Dermatol Alergol. 2016; 32(5):362-7. PMC: 4692821. DOI: 10.5114/pdia.2015.54746. View

Hall V, Leppard B, McGill J, Kesseler M, White J, Goodwin P . Treatment of basal-cell carcinoma: comparison of radiotherapy and cryotherapy. Clin Radiol. 1986; 37(1):33-4. DOI: 10.1016/s0009-9260(86)80161-1. View

Svoboda V, Kovarik J, Morris F . High dose-rate microselectron molds in the treatment of skin tumors. Int J Radiat Oncol Biol Phys. 1995; 31(4):967-72. DOI: 10.1016/0360-3016(94)00485-4. View

Prager W, Pohlmann S, Kunze S . [The indications for and results of HDR afterloading therapy in diseases of the skin and mucosa with standardized surface applicators (the Leipzig applicator)]. Strahlenther Onkol. 1999; 175(4):170-4. View

10.

Kalaghchi B, Esmati E, Ghalehtaki R, Gomar M, Jaberi R, Gholami S . High-dose-rate brachytherapy in treatment of non-melanoma skin cancer of head and neck region: preliminary results of a prospective single institution study. J Contemp Brachytherapy. 2018; 10(2):115-122. PMC: 5961526. DOI: 10.5114/jcb.2018.75596. View

11.

Likhacheva A, Devlin P, Shirvani S, Barker C, Beron P, Bhatnagar A . Skin surface brachytherapy: A survey of contemporary practice patterns. Brachytherapy. 2016; 16(1):223-229. PMC: 5413362. DOI: 10.1016/j.brachy.2016.10.006. View

12.

Guix B, Finestres F, Tello J, Palma C, Martinez A, Guix J . Treatment of skin carcinomas of the face by high-dose-rate brachytherapy and custom-made surface molds. Int J Radiat Oncol Biol Phys. 2000; 47(1):95-102. DOI: 10.1016/s0360-3016(99)00547-7. View

13.

Cox J, Stetz J, Pajak T . Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995; 31(5):1341-6. DOI: 10.1016/0360-3016(95)00060-C. View

14.

Pierquin B, Dutreix A, PAINE C, Chassagne D, Marinello G, Ash D . The Paris system in interstitial radiation therapy. Acta Radiol Oncol Radiat Phys Biol. 1978; 17(1):33-48. DOI: 10.3109/02841867809127689. View

15.

Arenas M, Arguis M, Diez-Presa L, Henriquez I, Murcia-Mejia M, Gascon M . Hypofractionated high-dose-rate plesiotherapy in nonmelanoma skin cancer treatment. Brachytherapy. 2015; 14(6):859-65. DOI: 10.1016/j.brachy.2015.09.001. View

16.

Olek Jr D, El-Ghamry M, Deb N, Thawani N, Shaver C, Mutyala S . Custom mold applicator high-dose-rate brachytherapy for nonmelanoma skin cancer-An analysis of 273 lesions. Brachytherapy. 2018; 17(3):601-608. DOI: 10.1016/j.brachy.2018.01.002. View

17.

Trott K, Maciejewski B, Skolyszewski J . Dose-response curve and split-dose recovery in human skin cancer. Radiother Oncol. 1984; 2(2):123-9. DOI: 10.1016/s0167-8140(84)80048-1. View

18.

Delishaj D, Laliscia C, Manfredi B, Ursino S, Pasqualetti F, Lombardo E . Non-melanoma skin cancer treated with high-dose-rate brachytherapy and Valencia applicator in elderly patients: a retrospective case series. J Contemp Brachytherapy. 2016; 7(6):437-44. PMC: 4716125. DOI: 10.5114/jcb.2015.55746. View