Hypofractionated High-Dose-Rate Brachytherapy in Nonmelanoma Skin Cancer Treatment

Abstract

Purpose/Objective(s)Non-melanoma skin cancer (NMSC) is the most frequently occurring cancer in humans. Different options currently exist to treat NMSC, such as topical treatments, surgery and radiation. The aim of this study was to analyze the outcomes, toxicity and cosmesis after patients (pts) with NMSC were treated by hypofractionated high dose rate brachytherapy (HHDR-B).Materials/Methods141 NMSC lesions were treated by HHDR-B. Hypofractionated treatment of 3 Gy was delivered three times a week, up to a total dose of between 45 and 54 Gy. A fixed applicator was used on 106 lesions, whereas a customized mould was used on 35 lesions.ResultsWith a median follow up of 24 months, local control at 2 years was 92%. Complete regression was achieved in the 96.45% of the lesions. Eleven treatment failures were observed: two partial responses, three with persistent disease, and six marginal field recurrences. Fifty-five pts (40%) had grade 2 or higher acute skin toxicity. Five patients (4.25%) had grade 4 acute skin toxicity. The cosmesis outcomes were excellent or good in 82% of pts and fair in 10% of pts.ConclusionsHHDR-B is an effective and well-tolerated treatment for non-melanoma skin cancer. Purpose/Objective(s)Non-melanoma skin cancer (NMSC) is the most frequently occurring cancer in humans. Different options currently exist to treat NMSC, such as topical treatments, surgery and radiation. The aim of this study was to analyze the outcomes, toxicity and cosmesis after patients (pts) with NMSC were treated by hypofractionated high dose rate brachytherapy (HHDR-B). Non-melanoma skin cancer (NMSC) is the most frequently occurring cancer in humans. Different options currently exist to treat NMSC, such as topical treatments, surgery and radiation. The aim of this study was to analyze the outcomes, toxicity and cosmesis after patients (pts) with NMSC were treated by hypofractionated high dose rate brachytherapy (HHDR-B). Materials/Methods141 NMSC lesions were treated by HHDR-B. Hypofractionated treatment of 3 Gy was delivered three times a week, up to a total dose of between 45 and 54 Gy. A fixed applicator was used on 106 lesions, whereas a customized mould was used on 35 lesions. 141 NMSC lesions were treated by HHDR-B. Hypofractionated treatment of 3 Gy was delivered three times a week, up to a total dose of between 45 and 54 Gy. A fixed applicator was used on 106 lesions, whereas a customized mould was used on 35 lesions. ResultsWith a median follow up of 24 months, local control at 2 years was 92%. Complete regression was achieved in the 96.45% of the lesions. Eleven treatment failures were observed: two partial responses, three with persistent disease, and six marginal field recurrences. Fifty-five pts (40%) had grade 2 or higher acute skin toxicity. Five patients (4.25%) had grade 4 acute skin toxicity. The cosmesis outcomes were excellent or good in 82% of pts and fair in 10% of pts. With a median follow up of 24 months, local control at 2 years was 92%. Complete regression was achieved in the 96.45% of the lesions. Eleven treatment failures were observed: two partial responses, three with persistent disease, and six marginal field recurrences. Fifty-five pts (40%) had grade 2 or higher acute skin toxicity. Five patients (4.25%) had grade 4 acute skin toxicity. The cosmesis outcomes were excellent or good in 82% of pts and fair in 10% of pts. ConclusionsHHDR-B is an effective and well-tolerated treatment for non-melanoma skin cancer. HHDR-B is an effective and well-tolerated treatment for non-melanoma skin cancer.