Electronic brachytherapy for treatment of non-melanoma skin cancers: clinical results and toxicities.
| Autor: | Goyal U; Banner MD Anderson Cancer Center and University of Arizona, Phoenix, USA., Cheung MK; Veterans Affair West Los Angeles Healthcare System, Radiation Oncology, Los Angeles, USA., Suszko J; RadiantCare, Lacey, USA., Laughlin B; Department of Radiation Oncology, Mayo Clinic, Phoenix, USA., Kim Y; Department of Radiation Oncology, Banner University Medical Center Tucson, USA., Askam J; Department of Radiation Oncology, Banner University Medical Center Tucson, USA., Arif-Tiwari H; Department of Medical Imaging, Banner University Medical Center, Tucson, USA., Slane B; Lawrence Cancer Center, Radiation Oncology, Lawrence, USA., Gordon J; Intermountain Healthcare, Salt Lake City, USA., Stea B; Department of Radiation Oncology, Banner University Medical Center Tucson, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of contemporary brachytherapy [J Contemp Brachytherapy] 2021 Oct; Vol. 13 (5), pp. 497-503. Date of Electronic Publication: 2021 Oct 06. |
| DOI: | 10.5114/jcb.2021.109753 |
| Abstrakt: | Purpose: Although surgical approaches are standard for most non-melanomatous skin cancers, some patients are not candidates due to medical co-morbidities or functional or cosmetic or lesion location. High-dose-rate electronic brachytherapy (HDR-EBT) may be an alternative treatment modality. Material and Methods: A retrospective chart review was conducted from April 2011 to April 2013. All lesions were pathologically confirmed as malignant basal cell or squamous cell carcinoma. A HDR-EBT system delivered a median biological equivalent dose of 50 Gy total to a depth of 0.1-0.5 cm using various sizes of applicators. Treatment feasibility, acute and late toxicity, cosmetic outcomes, and local recurrence were assessed. Results: Thirty-three patients with a mean age of 76 years with 50 cutaneous lesions were treated. Locations included 17 extremity lesions and 33 head and neck lesions. After treatments, acute grade 3 moist desquamation developed in 9 of the lesions (18%). Acute grade 4 ulceration developed in 3 lesions in the lower extremity (6%) and 1 upper lip lesion (2%). These toxicities were improved after a median of 20 days. Amongst the 4 lesions with grade 4 toxicities, a greater proportion were in lower extremity lesions compared to head and neck lesions (75% vs. 25%). There was no difference in the rate of grade 3 and 4 toxicities between patients aged ≤ 75 years and aged > 75 years ( p = 0.082). With a mean long-term follow-up of 45.6 months, there was 1 local recurrence treated with surgery and no reported late toxicities. Conclusions: Our experience with HDR-EBT for non-melanomatous skin cancers is encouraging in terms of efficacy and convenience for patients. Our long-term follow-up shows a good response in all treated sites. Caution should be used for extremity sites, and more fractionated regimens should be considered to avoid severe acute toxicities. Competing Interests: The authors report no conflict of interest. (Copyright © 2021 Termedia.) |
| Databáze: | MEDLINE |
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