Original paper Efficacy and safety of electronic brachytherapy for superficial and nodular basal cell carcinoma

Abstract

PurposeSurface electronic brachytherapy (EBT) is an alternative radiotherapy solution to external beam electron radiotherapy and high-dose-rate radionuclide-based brachytherapy. In fact, it is also an alternative solution to surgery for a subgroup of patients. The objective of this work is to confirm the clinical efficacy, toxicity and cosmesis of a new EBT system, namely Esteya® in the treatment of nodular and superficial basal cell carcinoma (BCC).Material and methodsThis is a prospective single-center, non-randomized pilot study to assess the efficacy and safety of EBT in nodular and superficial BCC using the Esteya® system. The study was conducted from June 2014 to February 2015. The follow up time was 6 months for all cases.ResultsTwenty patients with 23 lesions were included. A complete response was documented in all lesions (100%). A low level of toxicity was observed after the 4th fraction in all cases. Erythema was the most frequent adverse event. Cosmesis was excellent, with more than 60% of cases without skin alteration and with subtle changes in the rest.ConclusionsElectronic brachytherapy with Esteya® appears to be an effective, simple, safe, and comfortable treatment for nodular and superficial BCC associated with excellent cosmesis. It could be a good choice for elderly patients, patients with contraindications for surgery (due to comorbidities or anticoagulant drugs) or patients where surgery would result in a more disfiguring outcome. A longer follow-up and more studies are needed to confirm these preliminary results.

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

“…7 Gy per fraction given at the prescription depth (typically 3 mm) [34]. This is delivered twice weekly with a minimum interval of 48 hours.…”

Successful treatment of topical imiquimod‐resistant basal cell carcinoma by electronic X‐ray brachytherapy

“…Although there is limited research on brachytherapy, some studies have shown that electronic brachytherapy (EBT), a type of contact radiotherapy, is an effective and safe option for superficial and nodular BCC. 6 In this study, the authors found that, even with tumor thickness averaging 4 mm, a complete response to EBT was documented in all lesions after 42 Gy divided in 6 fractions of 7 Gy. Moreover, only mild adverse events and good cosmetic outcomes were noted.…”

“…Moreover, only mild adverse events and good cosmetic outcomes were noted. 6 The recurrence rate of radiotherapy is around 3.5%, comparable to surgical excision (3.8%), as well as to Mohs surgery (3.8%). 7 After EBT, our patient experienced a full resolution of a 2-mm thick BCC with minimal local erythema, which was demonstrated dermoscopically and histologically.…”

Treatment of Non-Melanomatous Skin Cancer with Radiotherapy

“…A prospective, single-center, non-randomized study reported preliminary data for the treatment of BCC with the Esteya device [61]. Twenty patients with 23 lesions exhibited complete response with no recurrence at 6-month follow-up.…”