High-dose-rate brachytherapy for non-melanoma skin cancer using tailored custom moulds – a single-centre experience

Concetta Laliscia; Taiusha Fuentes; Natalina Coccia; Roberto Mattioni; Franco Perrone; Fabiola Paiar

doi:10.5114/wo.2021.104688

eISSN: 1897-4309
ISSN: 1428-2526

Contemporary Oncology/Współczesna Onkologia

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1/2021
vol. 25

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abstract:

Original paper

High-dose-rate brachytherapy for non-melanoma skin cancer using tailored custom moulds – a single-centre experience

Concetta Laliscia

¹

,

Taiusha Fuentes

¹

,

Natalina Coccia

¹

,

Roberto Mattioni

¹

,

Franco Perrone

²

,

Fabiola Paiar

¹

Division of Radiation Oncology, University of Pisa, Pisa, Italy
Medical Physics, University of Pisa, Pisa, Italy

Contemp Oncol (Pozn) 2021; 25 (1): 12–16

DOI: https://doi.org/10.5114/wo.2021.104688

Online publish date: 2021/03/24

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Introduction
The aim of this retrospective study was to analyse tumour control, toxicity, and aesthetic outcome of patients affected by non-melanoma skin cancer (NMSC) treated with 192 Ir high-dose-rate (HDR)-brachytherapy (BT) at the Division of Radiotherapy, University of Pisa.

Material and methods
From January 2014 to December 2019 we treated 37 patients (median age 79 years; range 31–91 years) affected by NMSC, with the following histological subtypes: 62.2% basal cell carcinoma and 37.8% squamous cell carcinoma. We analysed 40 lesions with a depth ≤ 5 mm, located in 40.0% scalp, 17.5% nose, 25.0% face, and 17.5% ear, all treated with 192 Ir-based HDR-BT, using tailored custom moulds, with a median of 5 catheters (range, 1–9) spaced 1 cm apart. The most common fractionation scheme was 40 Gy in 8 daily fractions; the biological effective dose was 60 Gy.

Results
The median follow-up was 25 months (range, 3–70 months). The 2-year local control rate was 90%. Common terminology criteria for adverse event (CTCAE vs. 5.0) G1 toxicities were dermatitis (52%), pain (25%), and ulceration (22%). The only G2 acute toxicities were dermatitis and ulceration. The most common G1 late toxicities were fibrosis (17%), atrophy (15%), and hypopigmentation (12%). No G3 or higher acute or late toxicity was reported. Excellent cosmetic results were observed in 65.0% of the lesions; only 1 case (2.5%) reported a poor cosmetic result.

Conclusions
Surface mould HDR-BT is a safe, effective, and well tolerated treatment modality for NMSC and can be considered a good alternative, especially for elderly patients who are often unfit for surgery.

keywords:

High-dose-rate brachytherapy for non-melanoma skin cancer using tailored custom moulds – a single-centre experience

Concetta Laliscia 1 , Taiusha Fuentes 1 , Natalina Coccia 1 , Roberto Mattioni 1 , Franco Perrone 2 , Fabiola Paiar 1

non-melanoma skin cancer, radiotherapy, brachytherapy, surface custom moulds

Concetta Laliscia

¹

,

Taiusha Fuentes

¹

,

Natalina Coccia

¹

,

Roberto Mattioni

¹

,

Franco Perrone

²

,

Fabiola Paiar

¹