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ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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5/2019
vol. 11
 
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abstract:
Original paper

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

Andrea Vavassori
1
,
Giulia Riva
1, 2
,
Stefano Durante
1, 2
,
Cristiana Fodor
1
,
Stefania Comi
3
,
Raffaella Cambria
3
,
Federica Cattani
3
,
Giuseppe Spadola
4
,
Roberto Orecchia
5
,
Barbara Alicja Jereczek-Fossa
1, 2

  1. Department of Radiotherapy, IEO European Institute of Oncology IRCCS, Milan, Italy
  2. Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
  3. Unit of Medical Physics, IEO European Institute of Oncology IRCCS, Milan, Italy
  4. Melanoma, Sarcoma and Rare Tumors Surgery Department, IEO European Institute of Oncology IRCCS, Milan, Italy
  5. Scientific Directorate, IEO European Institute of Oncology IRCCS, Milan, Italy
J Contemp Brachytherapy 2019; 11, 5: 443–448
DOI: https://doi.org/10.5114/jcb.2019.88619
Online publish date: 2019/10/09
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Purpose
To evaluate toxicity and clinical outcomes in patients with eyelid tumour treated with contact high-dose-rate brachytherapy (HDR-BT).

Material and methods
Between April 2010 and August 2017, 10 consecutive patients with tumour of the eyelid underwent contact HDR-BT and custom-made surface mould. Every applicator was manually built using conventional thermoplastic material and standard plastic catheters. The median dose prescribed was 42 Gy (range, 30-48) with a median dose per fraction of 3.5 Gy (range, 2-4.5). The dose was delivered in a median of 12 fractions (range, 10-17) over a median of 16 days. In all cases, an ocular shield was placed to reduce the dose to the eye. Acute and late toxicity was evaluated according to RTOG toxicity criteria.

Results
We analyzed data of 9 of 10 patients (one patient was excluded because he did not give consent for investigation). The median age was 68 years (range, 31-88). According to the TNM-UICC staging system, 4, 1 and 4 patients were stage IA, IB and IC, respectively. Basal cell and sebaceous gland carcinomas were reported in 5 and 2 patients, respectively; other histological types were non-Hodgkin lymphoma and plasmacytoma. After a median follow-up of 51 months (range, 16-90), there was no evidence of local or distant recurrence. The treatment was very well tolerated. Most commonly acute reactions consisted of low grade (G1-G2) conjunctivitis and skin erythema. Only one patient required a temporary interruption of the treatment due to acute G2 conjunctivitis and G3 lid erythema. Only one G2 late toxicity was reported (corneal ulceration), without resulting in functional impairment or blindness.

Conclusions
Our results suggest that contact HDR-BT with a customized applicator is safe, effective and offers very good local control and can be considered for the treatment of eyelid tumours.

keywords:

HDR, brachytherapy, eyelid, HDR-BT

  
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