Customized 3D‐printed molds for high dose‐rate brachytherapy in facial skin cancer: First clinical experience

Abstract

Summary Background and Objective Radiotherapy of elderly, frail patients with facial skin cancer in proximity to critical organs is challenging. This is the first report on clinical experience with facial skin cancer treated by individualized 3D‐printer‐based mold high‐dose‐rate (HDR) brachytherapy (BT). Patients and Methods Fifteen patients not eligible for radical surgery or definitive external beam radiotherapy (EBRT) were treated with 3D‐printer‐based mold HDR‐BT. Patient selection and treatment were in accordance with multidisciplinary tumor board recommendations. Clinical response, toxicity and cosmesis were analyzed. Results Median age was 77 years. Histology revealed squamous cell carcinoma in seven, basal cell carcinoma in five, melanoma in situ in one, Lentigo maligna in one, and melanoma in one patient, respectively. Median prescription dose was 39 Gy delivered in once‐daily fractions of 3 Gy. After a median follow‐up of 12.2 months, local recurrence was observed in one patient with melanoma in situ. Apart from one grade 4 cataract, no other > grade 2 late toxicity was documented. Conclusions HDR‐BT with 3D‐printer‐based molds for facial skin cancer is a well‐tolerated and safe treatment option for elderly, frail patients not eligible for radical surgery or definitive EBRT due to functional inoperability or tumor location.

Multilayer intensity modulated contact interventional radiotherapy (brachytherapy): Stretching the therapeutic window in skin cancer

“…The results obtained in our analysis may be used in several clinical applications, including Freiburg flaps, and individualized moulds either manually manufactured or 3D-printed [ 20 ]. In particular, there is a possibility of designing multi-depth catheter placements based on lesion thickness in 3D-printed applicators.…”

Dosimetric impact of applying a model-based dose calculation algorithm for skin cancer brachytherapy (interventional radiotherapy)

“…Particularly, in the case of face NMSC, high-risk zones can be identified, including eyelids, nose vestibule, and lips, which usually require an interstitial approach [ 15 ]; on the contrary, for non-high-risk zones, contact BT can be used. However, for the current study, we considered that contact BT would present additional confounding factors in calculations because molds can be home-made [ 16 ], customized from commercially available flaps [ 1 ], or even 3D-printed [ 17 , 18 ]. Regarding specific anatomical subsite of high-risk NMSC, we decided that the eyelid was the ideal choice both from practical point of view and for clinical relevance of the findings.…”

Brachytherapy Method Using Individualized Applicators to Increase Efficiency in Skin Tumors Treatment

“…As a result of experiment, HDR-BT with 3D printer based molds for use in facial skin cancer is well tolerated for elderly, frail patients, functional inoperability, and who cannot undergo radical surgery due to tumor location or patients not suitable for definite EBRT. It has been determined to be a safe treatment option [12]. In study a conducted by G. Bieleda et al in 2022 developed an applicator with 3D printing in the brachytherapy treatment of skin cancer for the treatment of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) tumors.…”