HDR Brachytherapy with Standardized Surface Applicators in the Treatment of Superficial Malignant Skin Lesions

Ghaly, Maged; Zinkin, H.D.; Satchwill, Kenneth; Giorello, C.; Graham, L. Stephen; Serviss, Donna; Musmacher, J.

doi:10.1016/j.ijrobp.2008.06.1474

Cited by 14 publications

(28 citation statements)

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“…[20] described a standardized surface mold technique prospectively utilizing HDR brachytherapy in 236 NMSC lesions, and achieved 5-year local control of 98% with excellent treatment tolerance and no severe early or late complications. Similar results were reported by other authors [19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30] in their retrospective studies. Despite the potential interest in BT for the treatment of non-melanoma skin cancer, there are not a lot of randomized controlled trials, systematic reviews, and/or metanalyses in literature.…”

Section: Purposesupporting

confidence: 92%

“…In fact, during HDR-BT, the dose remains on the surface and does not penetrate deeply with optimal sparing of normal tissues due to dose concentration into the clinical target volumes (CTV) and rapid dose fall-off at target periphery [10, 11, 12, 13, 14, 15, 16, 17]. Published studies have mainly reported standard fractionation and hypofractionated brachytherapy regimens in patients treated with HDR-BT, and the biological effective dose (BED) was often calculated due to define the total dose and dose for fractions regimen for a better local control and acceptable late and acute toxicity [19, 20, 21, 22, 23, 24, 25, 26, 33, 34, 35, 36, 37]. …”

Section: Resultsmentioning

confidence: 99%

“…Moreover, HDR brachytherapy technique allows to treat with curative doses some localizations (such as cancer on face skin, near eyes and nose) with excellent and good cosmetic outcomes [18, 19, 20, 21, 22, 23, 24, 25, 26]. …”

Section: Purposementioning

confidence: 99%

“…While there is little level I evidence for traditional radiotherapy in the management of NMSC, there is no level I evidence for HDR brachytherapy. However, several retrospective and prospective studies with excellent results and adequate follow-up have been reported [19, 20, 21, 22, 23, 24, 25, 26]. …”

Section: Purposementioning

confidence: 99%

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

Delishaj¹,

Rembielak²,

Manfredi³

et al. 2016

jcb

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PurposeThe incidence of non-melanoma skin cancer (NMSC) has been increasing over the past 30 years. There are different treatment options and surgical excision is the most frequent treatment due to its low rates of recurrence. Radiotherapy is an effective alternative of surgery, and brachytherapy (BT) might be a better therapeutic option due to high radiation dose concentration to the tumor with rapid dose fall-off resulting in normal tissues sparing. The aim of this review was to evaluate the local control, toxicity, and cosmetic outcomes in NMSC treated with high-dose-rate BT (HDR-BT).Material and methodsIn May 2016, a systematic search of bibliographic database of PubMed, Web of Science, Scopus, and Cochrane Library with a combination of key words of “skin cancer”, “high dose rate brachytherapy”, “squamous cell carcinoma”, “basal cell carcinoma”, and “non melanoma skin cancer“ was performed. In this systematic review, we included randomized trials, non-randomized trials, prospective and retrospective studies in patients affected by NMSC treated with HDR-BT.ResultsOur searches generated a total of 85 results, and through a process of screening, 10 publications were selected for the review. Brachytherapy was well tolerated with acceptable toxicity and high local control rates (median: 97%). Cosmetic outcome was reported in seven study and consisted in an excellent and good cosmetic results in 94.8% of cases.ConclusionsBased on the review data, we can conclude that the treatment of NMSC with HDR-BT is effective with excellent and good cosmetics results, even in elderly patients. The hypofractionated course appears effective with very good local disease control. More data with large-scale randomized controlled trials are needed to assess the efficacy and safety of brachytherapy.

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Section: Purposesupporting

confidence: 92%

Section: Resultsmentioning

confidence: 99%

Section: Purposementioning

confidence: 99%

Section: Purposementioning

confidence: 99%

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

Delishaj¹,

Rembielak²,

Manfredi³

et al. 2016

jcb

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“…Tormo et al [10] also showed good toxicity results in patients treated in 6 or 7 fractions. Although most brachytherapy treatment schemas in the literature use 8 to 12 fractions [35,36,37,38,39,40], the fractionation used in this study does not result in a higher toxicity or a poorer cosmesis in comparison with a more fractionated treatment. Thus, in an elderly population, a comfortable schema that facilitates compliance is preferred.…”

Section: Discussionmentioning

confidence: 94%

Electronic brachytherapy for superficial and nodular basal cell carcinoma: a report of two prospective pilot trials using different doses

Ballester‐Sánchez¹,

Pons-Llanas

Candela-Juan

et al. 2016

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Purpose: Basal cell carcinoma (BCC) is a very common cancer in the Caucasian population. Treatment aims to eradicate the tumor with the lowest possible functional and aesthetic impact. Electronic brachytherapy (EBT) is a treatment technique currently emerging. This study aims to show the outcomes of two consecutive prospective pilot clinical trials using different radiation doses of EBT with Esteya ® EB system for the treatment of superficial and nodular basal cell carcinoma.Material and methods: Two prospective, single-center, non-randomized, pilot studies were conducted. Twenty patients were treated in each study with different doses. The first group (1) was treated with 36.6 Gy in 6 fractions of 6.1 Gy, and the second group (2) with 42 Gy in 6 fractions of 7 Gy. Cure rate, acute toxicity, and late toxicity related to cosmesis were analyzed in the two treatment groups.Results: In group 1, a complete response in 90% of cases was observed at the first year of follow-up, whereas in group 2, the complete response was 95%. The differences with reference to acute toxicity and the cosmetic results between the two treatment groups were not statistically significant.Conclusions: Our initial experience with Esteya ® EB system to treat superficial and nodular BCC shows that a dose of 36.6 Gy and 42 Gy delivered in 6 fraction of 7 Gy achieves a 90% and 95% clinical cure rate at 1 year, respectively. Both groups had a tolerable toxicity and a very good cosmesis. The role of EBT in the treatment of BCC is still to be defined. It will probably become an established option for selected patients in the near future.

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Surface dose characterisation of the Varian Ir-192 HDR conical surface applicator set with a vertically orientated source

et al. 2014

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A central underdosed area exceeding 15 % of the prescribed dose has not been previously reported. Source tilt was observed and found to affect clinical use and possibly treatment outcome in applicators using a vertically arranged source. Surface applicators with a vertically orientated source were subject to dose irregularities that could impact on chamber-based applicator output verification procedures. We recommend film dosimetry-backed applicator commissioning to avoid systematic errors.

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HDR Brachytherapy with Standardized Surface Applicators in the Treatment of Superficial Malignant Skin Lesions

Cited by 14 publications

References 0 publications

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

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

Electronic brachytherapy for superficial and nodular basal cell carcinoma: a report of two prospective pilot trials using different doses

Surface dose characterisation of the Varian Ir-192 HDR conical surface applicator set with a vertically orientated source

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