Mould-based surface high-dose-rate brachytherapy for eyelid carcinoma

Vavassori, Andrea; Riva, Giulia; Durante, Stefano; Fodor, C.; Comi, S.; Cambria, Raffaella; Cattani, Federica; Spadola, Giuseppe; Orecchia, Roberto; Jereczek‐Fossa, Barbara Alicja

doi:10.5114/jcb.2019.88619

Cited by 14 publications

(13 citation statements)

References 39 publications

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“…Current treatment options for NMSC of the face include local excision, Mohs micrographic surgery (MMS), and radiation therapy (RT) [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. Radiation can be delivered via external beam with megavoltage (MV) electrons, kilovoltage and MV photons, or using brachytherapy with low-dose-rate (LDR), high-dose-rate (HDR), and electronic HDR applicators [ 17 , 18 , 19 , 20 ].…”

Section: Purposementioning

confidence: 99%

Computed tomography-based flap brachytherapy for non-melanoma skin cancers of the face

Gogineni¹,

Cai²,

Carillo³

et al. 2021

jcb

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Purpose Non-melanoma skin cancers of the face are at high-risk for local recurrence and metastatic spread. While surgical interventions such as Mohs microsurgery are considered the standard of care, this modality has the potential for high rates of toxicity in sensitive areas of the face. Catheter flap high-dose-rate (HDR) brachytherapy has shown promising results, with high rates of local control and acceptable cosmetic outcomes. Material and methods Patients with non-melanoma skin cancers (NMSC) located on the face were treated with 40 Gy in 8 fractions, given twice weekly via catheter flap HDR brachytherapy. Clinical target volume (CTV) included the visible tumor plus a margin of 5 mm in all directions, with no additional planning target volume (PTV) margin. Results Fifty patients with 53 lesions on the face were included, with a median follow-up of 15 months. All were considered high-risk based on NCCN guidelines. Median tumor size and thickness were 18 mm and 5 mm, respectively. Median PTV volume and D 90 were 1.7 cc and 92%, respectively. Estimated rate of local control at twelve months was 92%. Three patients (5%) experienced acute grade 2 toxicity. Two patients (4%) continued to suffer from chronic grade 1 skin toxicity at 12 months post-radiotherapy (RT), with an additional two patients (4%) experiencing chronic grade 2 skin toxicity. Forty-nine lesions (92%) were found to have a good or excellent cosmetic outcome with complete tumor remission. Conclusions CT-based flap applicator brachytherapy is a valid treatment option for patients with NMSC of the face. This modality offers high rates of local control with acceptable cosmetic outcomes and low rates of toxicity.

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Section: Purposementioning

confidence: 99%

Computed tomography-based flap brachytherapy for non-melanoma skin cancers of the face

Gogineni¹,

Cai²,

Carillo³

et al. 2021

jcb

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“…An analysis of the available literature indicates the rarity of the use of interstitial HDR brachytherapy in the treatment of skin cancers in this location. Available analyses regarding HDR brachytherapy involve small groups of patients (8–20 patients) [ 14 , 15 , 16 , 17 , 18 ], and LDR brachytherapy is more common (20–160 patients) [ 19 , 20 , 21 , 22 , 23 ]. Studies indicate the high efficiency of brachytherapy, in the range of 94–100%, both among patients treated with HDR brachytherapy and LDR brachytherapy [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, no relapse or metastasis was observed in patients, and the cosmetic effects were satisfactory. These data indicate that this method is effective and safe in the treatment of eyelid s and may be an effective alternative to other therapies [ 18 ]. There are also reports indicating that the therapeutic and cosmetic effect of brachytherapy in this localization may be unfavorable [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Interstitial HDR Brachytherapy in the Treatment of Non-Melanocytic Skin Cancers around the Eye

Cisek

Kieszko²,

Bilski

et al. 2021

Cancers

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Background: Eyelid tumors are rare skin cancers, the most common of which is basal cell carcinoma characterized primarily by local growth. In addition to surgery, radiotherapy is among the basic methods of treatment. External beam radiotherapy is associated with the risk of complications within ocular structures, especially the lens. In the case of interstitial brachytherapy, it is possible to administer a high dose to the clinical target volume (CTV), while reducing it in the most sensitive structures. Methods: This paper presents the results of an analysis of 28 patients treated with interstitial high dose rate (HDR) brachytherapy for skin cancers of the upper and lower eyelid; medial and lateral canthus; and the cheek, nose and temples with the infiltration of ocular structures. The patients were treated according to two irradiation schedules: 49 Gy in 14 fractions of 3.5 Gy twice a day for 7 days of treatment, and 45 Gy in 5 Gy fractions twice a day for 5 days. The mean follow-up was 22 months (3–49 months). Results: two patients (6%) had a relapse: a local recurrence within the irradiated area in one of them, and metastases to lymph nodes in the other. The most common early complication was conjunctivitis (74%), and the most common late complication was dry eye syndrome (59%). Conclusions: Interstitial HDR brachytherapy for skin cancers of the upper and lower eyelid; medial and lateral cants; and the cheek, nose and temples with infiltration of ocular structures is a highly effective, short and relatively low burden type of treatment.

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“…First of all, it offers clear advantages in anatomical sites where organs at risk are very close to the target such as the eyelids, as shown by a systematic review about this topic (31). In particular, when dealing with eyelid NMSC, it is advisable to use ocular shields to further reduce the amount of dose reaching the eye (32). More generally, facial lesions are probably the most suitable for cHDR-RT being usually located on curved surface and near to organs at risk (33,34).…”

Section: Discussionmentioning

confidence: 99%

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

Tagliaferri

Ciardo

Fionda

et al. 2021

In Vivo

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Background/Aim: Non-melanoma skin cancers (NMSC) are the most common neoplasms worldwide and their incidence has been proven to increase in recent years and their treatment should aim at cancer cure as well as cosmetic and functional results. The aim of the study was to report the results of our mono-institutional series of highdose-rate radiotherapy (cHDR-RT) in NMSC, based on a homogenous technique and two different treatment schedules. Patients and Methods: All patients affected by NMSC who were consecutively evaluated and treated at our Interventional Oncology Center from October 2018 to August 2020, were included. Patients underwent cHDR-RT using flap applicators and remotely afterloaded Ir-192 sources. Results: Overall, 51 patients were treated for a total of 67 lesions. Local control (LC) and disease-specific survival (DSS) were 94.0% and 100%, respectively. Grade 1, grade 2, grade 3 and grade 4 acute toxicity rates were 24.6%, 3.5%, 3.5%, and 0.0%, respectively. The cosmetic results were graded as excellent/good, fair, and poor in 73.7%, 19.3%, and 7.0%. Conclusion: cHDR-RT of NMSC is an effective alternative to surgery due to excellent outcomes both in terms of local control and aesthetic results especially in the face.Non-melanoma skin cancers (NMSC) are the most common neoplasms worldwide and their incidence has been proven to increase in the recent years (1). The two most frequent NMSC are squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). Albeit with a better prognosis than other cancers, the NMSC treatment strategies should be properly selected considering the possible negative impact on quality of life of suboptimal cosmetic results (2). Therefore, treatment of NMSC should aim at cancer cure as well as cosmetic and functional results (3). Therapeutic options include surgery, radiotherapy (RT), and topical agents. More recently for locally advanced or metastatic tumors where curative surgery and curative radiotherapy are not feasible, 2313This article is freely accessible online.

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Mould-based surface high-dose-rate brachytherapy for eyelid carcinoma

Cited by 14 publications

References 39 publications

Computed tomography-based flap brachytherapy for non-melanoma skin cancers of the face

Computed tomography-based flap brachytherapy for non-melanoma skin cancers of the face

Interstitial HDR Brachytherapy in the Treatment of Non-Melanocytic Skin Cancers around the Eye

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

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