Novel treatment options for nonmelanoma skin cancer: focus on electronic brachytherapy

Kasper, Michael; Chaudhary, Amitabh

doi:10.2147/mder.s61585

Cited by 24 publications

(26 citation statements)

References 34 publications

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“…Electronic brachytherapy (eBT) has been evolving since the start of the 21st century and has become a treatment option for various tumor sites in different settings …”

Section: Introductionmentioning

confidence: 99%

Treatment of cervical cancer with electronic brachytherapy

Lozares

Gandía-Martínez

Miranda-Burgos

et al. 2019

J Applied Clin Med Phys

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Purpose We report the first cervical cancer cases treated with interstitial electronic brachytherapy (eBT) at our hospital and compare them with plans made with high‐dose‐rate interstitial brachytherapy based on Ir192 (HDR‐BT). Materials and methods Eight patients with cervical cancer were treated with the Axxent eBT device (Xoft, Inc.). Planning was with magnetic resonance imaging and computed tomography following the recommendations of the EMBRACE protocol. The dosimetry parameters of organs at risk (OAR) were evaluated for the bladder, rectum, and sigmoid colon (D2cc, D1cc, and D0.1cc). In addition, the V150 and V200 of irradiated tissue were compared for both eBT and HDR‐BT. All patients received intensity‐modulated external beam radiation therapy with a regimen of 23 sessions of 2 Gy followed by four sessions of 7 Gy of eBT performed over 2 weeks (two sessions followed by another two sessions a week later) following the EMBRACE recommendations. Each of the eight patients was followed to assess acute toxicity associated with treatment. Results The doses reaching OAR for eBT plans were lower than for HDR‐BT plans. As for acute toxicity associated with eBT, very few cases of mucositis were detected. No cases of rectal toxicity and one case with grade 1 urinary toxicity were detected. The results at 1 month are equally good, and no relapses have occurred to date. Conclusions The first results of treatment with the Axxent eBT device are promising, as no recurrences have been observed and toxicity is very low. eBT is a good alternative for treating cervical cancer in centers without access to conventional HDR.

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“…Electronic brachytherapy (eBT) has been evolving since the start of the 21st century and has become a treatment option for various tumor sites in different settings …”

Section: Introductionmentioning

confidence: 99%

Treatment of cervical cancer with electronic brachytherapy

Lozares

Gandía-Martínez

Miranda-Burgos

et al. 2019

J Applied Clin Med Phys

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“…Surgery remains the mainstay of treatment with local control rates of 98–99%. Recently, there has been renewed interest in offering definitive radiotherapy (RT) to a select group of patients with NMSC . In this retrospective study, we aim to compare local control rates for patients with T1‐2 squamous cell carcinomas (SCCs) and small basal cell carcinomas (BCCs) treated with definitive RT or Mohs.…”

Section: Baseline Characteristics Of the Patients Reviewedmentioning

confidence: 99%

Definitive radiotherapy versus Mohs surgery for early stage nonmelanoma skin cancers: a multi‐institutional retrospective comparison of local recurrence

et al. 2018

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“…This combination made it possible to obtain high-doses in the epidermis without damaging underlying layers. Depending on the radioactivity and the isotope used, brachytherapy with sealed sources is classified as low (0.4-2 Gy/h), medium (2-12 Gy/h) or high-dose-rate (>12 Gy/h), the high-dose-rate being the most commonly used [3].…”

Section: Introductionmentioning

confidence: 99%

Personalized High-Dose-Rate Brachytherapy with Non-Sealed Rhenium-188 in Non-Melanoma Skin Cancer

Cipriani¹

2017

Int. J. Nucl. Medi. Res.

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Objectives: Most non-melanoma skin tumors are treated with conventional methods, being the most common surgery. However, satisfactory surgical treatment can be very challenging for patients with large or multiple lesions. In cases where the tumor is located on the face, hands or genital areas, the results may be suboptimal in terms of aesthetics and/or function. A high dose-rate brachytherapy using non-sealed Rhenium-188 was developed to offer a personalized solution for these cases as well as cases where a surgical approach was not preferred. Here we show a retrospective analysis of 43 patients treated with this technique. Methods: The technique, called dermatological high-dose-rate beta-brachytherapy (DBBR), is a brachytherapy based on a non-sealed beta-emitter embedded in a complex specially-designed acrylic matrix. We use Rhenium-188 as the betaemitter. This matrix is applied over the tumor, which is protected by a special thin plastic foil avoiding any direct physical contact of the radioisotope with the skin. After the calculated required amount of time, the protective foil with the applied radioactive acrylic matrix is removed. 43 patients (basal/squamous cell carcinomas, BCCs and SCCs) were treated with this technique after histological confirmation of the non-melanoma skin tumor. Patients were then followed up, to evaluate wound healing as well as potential side-effects and recurrences. Results: 29 BCC and 14 SCC patients were treated with DBBR. 36/42 achieved complete clinical remission with only 1 application (24 BCC, 12 SCC) and 6/42 with 2 applications (4 BCC, 2 SCC); 1 BCC patient was lost to follow-up before wound closing. In 4 of the 6 patients (3 BCC, 1 SCC) treated twice the second treatment was planned due to the thickness of the tumor; in the remaining 2 patients (1 BCC, 1 SCC) the second treatment was needed to treat a recurrence at the border of the previously treated area. No side effects were reported. Wound healing was complete in 34-180 days (average 65 days, median 53) for all 42 patients that were followed-up. An average follow-up of 288 days (after one or two treatments) showed no single recurrence (42 patients). Conclusions: DBBR is a very promising alternative for treatment of BCCs and SCCs for all cases in which a surgical approach is not recommended or accepted by the patient.

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Novel treatment options for nonmelanoma skin cancer: focus on electronic brachytherapy

Cited by 24 publications

References 34 publications

Treatment of cervical cancer with electronic brachytherapy

Treatment of cervical cancer with electronic brachytherapy

Definitive radiotherapy versus Mohs surgery for early stage nonmelanoma skin cancers: a multi‐institutional retrospective comparison of local recurrence

Personalized High-Dose-Rate Brachytherapy with Non-Sealed Rhenium-188 in Non-Melanoma Skin Cancer

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