Abstract
<h3>Purpose</h3> Surface Mold Brachytherapy (SMBT) is an established treatment modality in skin cancer especially in accessible areas and provides outcomes comparable to surgery. We present our results for the skin tumor treatment with SMBT treated with High-dose rate (HDR) brachytherapy in terms of clinical outcomes and toxicity at our institute. <h3>Materials and Methods</h3> this retrospective analysis among skin cancer patients with skin tumors treated at our institute between January 2020 to July 2021 were assessed and a total of 15 patients were evaluated. The patient and disease characteristics were assessed and patients were treated using HDR- Surface Mold Brachytherapy using Iridium-192. The median dose was 40Gy in 10 fractions. The dosimetric parameters were assessed and patients were followed-up as per the institutional protocol. All patients underwent individualized CT-based planning. Skin toxicity was assessed using Dermatology Life Quality Index (DLQI). <h3>Results</h3> With majority of the patients being male, the median age was 59 years and most common site being the face (8/15; 53.3%). The histopathology included 7 Squamous cell carcinoma, 6 Basal cell carcinoma and a single case of sebaceous cell carcinoma. The median depth of invasion was 4 mm and median catheter to surface distance was 1 mm. The Complete response rate among the 10 definitive cases was 90% and partial response in one case. The treatment was well-tolerated with no Grade 3-5 toxicities. The median V95% and V90% were 95.42% and 97.37% respectively. The mean Coverage Index (C.I), Dose non-uniformity ratio (DNR) and overdose volume index (ODI) were 0.97, 0.36 and 0.04 respectively. After a median follow-up of 6 months, none of the patients had recurrence. On assessment of DLQI, the scores were found to be significant in association with the tumor size and tumor site with scores favoring <2cm and non-exposed area lesions. <h3>Conclusion</h3> Surface mould brachytherapy is a safe and effective treatment modality for skin tumours providing excellent response and cosmetic outcomes. It is well-tolerated and a non-invasive option for elderly patients with comorbidities and lesions in inoperable areas.
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