High-dose-rate plesiotherapy with customized molds in non-melanoma skin cancer: efficacy and safety at 10 years—single institution experience

Abstract

Purpose Our center adopted high-dose-rate brachytherapy with surface applicators (plesiotherapy) in 2008, creating custom molds to treat irregular areas. This study describes the efficacy and safety outcomes after extensive follow-up in the patients. Methods/patients We planned the treatment using two computed tomography (CT) scans: the first to delineate the lesion and the second after placing the thermoplastic mold. Fusing the two CT images enables planning of the target volume and pinpointing, where the catheters are in the mold. Results Seventy patients received plesiotherapy, either exclusively or following excision in patients with risk factors for recurrence. Those receiving plesiotherapy alone showed a complete response rate of 95.8%, and recurrences occurred in 5.7% at a mean follow-up of 96.2 months. Chronic toxicity appeared in 26.6% of patients, but severity was limited to grade 1 or 2. Conclusions High-dose-rate brachytherapy with customized molds yields a high rate of complete response, with long-term recurrence rates in line with similar studies and an acceptable toxicity rate.

High dose rate brachytherapy in nonmelanoma skin cancer—Systematic review

“…Even in the same institution various dose fractionation schedules were used. Despite that local control rate remains high in both short‐ and long‐term observations 19–32 and varies between 71% and 99%.…”

“…Among presented data in total 2403 patients with BCC and SCC were treated with average local control of 91.2% (between71% and 99%) 19–32 . It is worth mentioning that presented studies were heterogenic.…”

“…Most of them reported only very good tolerance. Detailed description of clinical presentation of adverse effects was presented by Guix, 20 Olek, 26 Casey, 28 Gogineni, 31 and Conejo 32 . Dominant acute radiodermatitis was presented as erythema grade 1 or grade 2 (According to RTOG/EORTC).…”

“…Dominant acute radiodermatitis was presented as erythema grade 1 or grade 2 (According to RTOG/EORTC). Due to high precision in dose delivery all adverse effects were limited to about 1 cm radius around tumors 19–32 . Exception was G1–2 conjunctivitis accompanying treatment of tumors of the periorbital area 28 .…”

“…Exception was G1–2 conjunctivitis accompanying treatment of tumors of the periorbital area 28 . Acute symptoms were relieved within 3 months from treatment 19–32 …”