Brachytherapy in the treatment of skin cancer: an overview

Abstract

The incidence of skin cancer worldwide is constantly growing and it is the most frequently diagnosed tumor. Brachytherapy (BT) in particular localizations is a valuable tool of the exact radiation depot inside the tumor mass. In localizations such as the face, skull skin and inoperable tumors, relapses after surgery, radiotherapy are usually not suitable for primary or secondary invasive treatment. Brachytherapy is a safe procedure for organs at risk according to rapid fall of a dose outside the axis of the applicator with satisfactory dose localization inside the target. The complications rate is acceptable and treatment costs are low. In some tumors (great skin lesions in the scalp, near eyes or on the nose) BT allows for a great dose reduction in surrounding healthy tissues. Brachytherapy provides minimal dose delivery to surrounding healthy tissue, thus enabling good functional and cosmetic results. Treatment is possible almost in all cases on an outpatient basis.

Non-melanoma skin cancer treated with high-dose-rate brachytherapy: a review of literature

“…The development of new devices for small skin tumor treatment and the introduction of commercial electronic BT have attracted considerable interest for BT as a skin cancer treatment. Despite the new technologies available, few studies have focused on the treatment of NMSC with HDR-BT and hypofractionated regimes seems to be a valid option for the treatment of NMSC with very good local control, toxicity, and cosmetic result [19, 20, 21, 22, 23, 24, 25, 26, 32, 33, 34, 35, 36, 37, 43, 44]. In 1999, Köhler-Brock et al .…”

GEC-ESTRO ACROP recommendations in skin brachytherapy

“…In order to reduce the treatment time and to avoid dependence on HDR equipment and a brachytherapy facility, several electronic solutions have been implemented, leading to development of electronic based applicators [8]. Currently, three major electronic applicator systems can be used for skin cancer.…”

Commissioning and quality assurance procedures for the HDR Valencia skin applicators

“…Specific shielded applicators have been developed to focus the absorbed dose to the tumor volume, thus reducing absorbed dose to the surrounding healthy tissues. This is the case of the Valencia skin applicators (Nucletron, an Elekta company, Elekta AB, Stockholm, Sweden) [2, 3, 4, 5, 6, 7, 8, 9, 10, 11]. They are tungsten cup shaped, in which the source has one single dwell position that incorporates a flattering filter providing a homogenous dose distribution at a given depth (see Figure 1).…”