Surface Mould Brachytherapy for Skin Cancers: The British Columbia Cancer Experience

Abstract

To report on skin tumor treatment with surface mould brachytherapy at our institution. Methods This was a retrospective review for all patients with skin tumors treated using Ir-192 high dose rate (HDR) surface mould brachytherapy from January 1, 2010 to December 31, 2017 in British Columbia. We identified 65 lesions (59 patients). Median age at diagnosis was 83 (range = 45-97). The majority were basal cell (54%, n = 35) or squamous cell carcinomas (31%, n = 20). Most lesions were located in the head and neck region. The most commonly used RT dose was 40 Gy/10 fractions; all patients had individualized CT-based planning. Results The two-year overall survival (OS) was 77.6% and two-year progression-free survival (PFS) was 71.5%. Most deaths were from unrelated causes. Response was assessed in clinic 2-4 months post-treatment. Our complete response (CR) rate was 96.8%, with partial response in two patients; two patients could not be assessed for response. We report a two-year local control (LC) rate of 84.9%, and local recurrence in five patients. The procedure was well tolerated, with no grade 3-5 acute or late toxicities. There was one case of grade 2 radionecrosis (Common Terminology Criteria for Adverse Events (CTCAE) v. 4.03). The 100% isodose line median depth was 0.5 cm, and median surface dose = 126.5%. The median V 90 = 92.3%. Conclusion Surface mould brachytherapy for skin tumors is a safe and effective modality, with excellent response rates. It is well-tolerated and a non-invasive option for elderly patients with comorbidities.

Non-melanoma Skin Cancer Treated by Contact High-dose-rate Radiotherapy (Brachytherapy): A Mono-institutional Series and Literature Review

“…The two-year outcomes of our study are very encouraging and confirm the results of previous analyses reporting favorable outcomes after cHDR-RT of NMSC (16). More generally, ours and other reports show that cHDR-RT represents an effective and safe therapeutic option for NMSCs, as confirmed by their inclusion in several international guidelines published in recent years (17)(18).…”

Individualized mould-based high-dose-rate brachytherapy for perinasal skin tumors: technique evaluation from a dosimetric point of view

“…Lesions difficult to treat with EBRT due to size or locations close to OARs can be safely and efficiently treated with this approach. The dose and prescription concepts of our dosimetrically analyzed series are in line with recent clinical reports and international patterns of practice survey results [ 3 , 7 , 10 , 11 ]. At a median follow-up of 165 days (range, 96-449 days), all patients showed complete clinical response with treatment plans described in this study.…”

High-dose-rate brachytherapy for non-melanoma skin cancer using tailored custom moulds – a single-centre experience

“…Casey et al . [ 7 ] used several doses, but 40 Gy in 10 daily fractions was the most commonly used dose fractionation (48.2%). Also, in our cohort we used different fractionation schedules, but the most common prescribed total dose was 40 Gy in 8 daily fractions.…”

“…High-dose-rate (HDR) BT is a highly tailored treatment for lesions ≤ 5 mm deep; otherwise, interstitial BT is preferred. Patients treated with HDR-BT for non-melanoma skin malignancies show 85–100% of local control (LC) [ 7 ]. The new emerging electronic BT provides an alternative to radioactive isotope sources (usually iridium-192 [ 192 Ir]) [ 8 ].…”