Complete response of endemic Kaposi sarcoma lesions with high-dose-rate brachytherapy: Treatment method, results, and toxicity using skin surface applicators

Comparison of 192Ir, 169Yb, and 60Co high‐dose rate brachytherapy sources for skin cancer treatment

“…[2][3][4][5] A treatment option is selected based on the available modalities offered by the clinics, the expertise of the attending specialist, and the anatomical location of the lesion. A variety of radiotherapy techniques (with varying tumor control rates) such as superficial (91-99%) 5 and orthovoltage Xrays (78-99%), 5 external electron beam therapy (75-95%), 5 and high-dose rate (HDR) brachytherapy (90.2-100%) 2,5,6 have been reported. The 192 Ir HDR brachytherapy source using various conical-shaped applicators have been reported [7][8][9][10][11][12][13] to be effect treatment options for small and shallow skin lesions (depth < 5 mm).…”

“…The 192 Ir HDR brachytherapy source using various conical-shaped applicators have been reported [7][8][9][10][11][12][13] to be effect treatment options for small and shallow skin lesions (depth < 5 mm). 2,[6][7][8][9] These conical-shaped tungsten alloy applicators shield the surrounding normal tissues and limit the radiation exposure to the target volume. Prior to the HDR treatment, noninvasive imaging techniques 2 are used to select the appropriate applicator for adequate disease coverage, the extension and depth of the lesions.…”

Optimum radiation source for radiation therapy of skin cancer

“…In radiation therapy, X‐rays or electron beams may be used to treat local skin cancers. A variety of radiation therapy techniques are used including superficial X‐rays, (4) orthovoltage X‐rays, (5) megavoltage photons, (4) electron beam therapy, (4) and brachytherapy 2 , 3 , 6 , 7 . Several groups have shown different percentages of tumor control results for nonmelanoma skin cancer treatment using superficial X‐rays with 93%–100%, (4) orthovoltage X‐rays with 87%, (8) electron beams with 72%–88%, (4) isotope‐based HDR brachytherapy with 92%–98%, (6) and 100% for eBT up to 2013 (6) …”

“…However, for a superficial X‐ray, dose falloff is exponential with the maximum dose being at the skin level. Generally for external electron beam therapy, a protocol with about 40 Gy to 60 Gy total dose is delivered at the rate of 2 Gy to 3 Gy per fractions within four to six weeks 4 , 6 . However, for brachytherapy, skin treatment by IR‐HDRs and eBT, the patient receives 6 to 8 fractions for a total dose ranging from 30 Gy to 40 Gy in two weeks 3 , 7 , 9 , 10 , 11 .…”

Brachytherapy

“…Success has also been reported for palliative treatments of Kaposi's sarcoma, cutaneous metastatic melanoma, angiosarcoma, Merkel cell metastases as well as T-cell and B-cell lymphomas. [184][185][186][187] Doses and fractionation for these treatments differ significantly. Superficial treatments using brachytherapy in the postoperative setting are also described for keloid scarring using dose ranges between 15 and 20 Gy in 3to 10 fractions.…”