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HDR Brachytherapy for Superficial Non‐Melanoma Skin Cancers
Author(s) -
Gauden Ruth,
Pracy Martin,
Avery AnneMarie,
Hodgetts Ian,
Gauden Stan
Publication year - 2013
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/j.1754-9485.2012.02466.x
Subject(s) - medicine , cosmesis , brachytherapy , radiation therapy , melanoma , basal cell carcinoma , nuclear medicine , basal cell , surgery , radiology , cancer research
Abstract Introduction Our initial experience using recommended high dose per fraction skin brachytherapy ( BT ) treatment schedules, resulted in poor cosmesis. This study aimed to assess in a prospective group of patients the use of L eipzig surface applicators for High Dose Rate ( HDR ) brachytherapy, for the treatment of small non‐melanoma skin cancers ( NMSC ) using a protracted treatment schedule. Method Treatment was delivered by HDR brachytherapy with L eipzig applicators. 36 Gy , prescribed to between 3 to 4 mm, was given in daily 3 Gy fractions. Acute skin toxicity was evaluated weekly during irradiation using the Radiation Therapy Oncology Group criteria. Local response, late skin effects and cosmetic results were monitored at periodic intervals after treatment completion. Results From M arch 2002, 200 patients with 236 lesions were treated. Median follow‐up was 66 months (range 25–121 months). A total of 162 lesions were macroscopic, while in 74 cases, BT was given after resection because of positive microscopic margins. There were 121 lesions that were basal cell carcinomas, and 115 were squamous cell carcinomas. Lesions were located on the head and neck (198), the extremities (26) and trunk (12). Local control was 232/236 (98%). Four patients required further surgery to treat recurrence. Grade 1 acute skin toxicity was detected in 168 treated lesions (71%) and grade 2 in 81 (34%). Cosmesis was good or excellent in 208 cases (88%). Late skin hypopigmentation changes were observed in 13 cases (5.5%). Conclusion Delivering 36 Gy over 2 weeks to superficial NMSC using HDR brachytherapy is well tolerated and provides a high local control rate without significant toxicity.