Clinical and toxicity outcomes with 3D based-HDR surface mold brachytherapy in skin cancer.
Humans
Brachytherapy
/ adverse effects
Male
Middle Aged
Skin Neoplasms
/ radiotherapy
Female
Retrospective Studies
Aged
Radiotherapy Dosage
Adult
Iridium Radioisotopes
/ therapeutic use
Treatment Outcome
Radiotherapy Planning, Computer-Assisted
/ methods
Carcinoma, Basal Cell
/ radiotherapy
Follow-Up Studies
Carcinoma, Squamous Cell
/ radiotherapy
Quality of Life
Journal
Journal of cancer research and therapeutics
ISSN: 1998-4138
Titre abrégé: J Cancer Res Ther
Pays: India
ID NLM: 101249598
Informations de publication
Date de publication:
01 Apr 2024
01 Apr 2024
Historique:
received:
16
12
2022
accepted:
18
03
2024
medline:
18
7
2024
pubmed:
18
7
2024
entrez:
18
7
2024
Statut:
ppublish
Résumé
Surface mold brachytherapy (SMBT) is an established treatment modality in skin cancer, especially in accessible areas, and has shown comparable outcomes to surgery. We have presented our results for the skin tumor treatment with SMBT treated with high-dose-rate (HDR) brachytherapy in terms of clinical outcomes and toxicity at our institute. In this retrospective analysis, 15 patients with skin cancer were treated with customized tube-based SMBT at our institute between January 2019 and July 2021. The patients were treated using HDR-brachytherapy using Iridium-192. The median dose was 40 Gy in 10 fractions. The dosimetric parameters were assessed, and patients were followed up as per the institutional protocol. All patients underwent individualized CT-based planning. Skin toxicity was assessed using the Dermatology Life Quality Index (DLQI). With the majority of the patients being male, the median age was 59 years and the most common site affected was the face (8/15; 53.3%). Among the 15 cases, five were squamous cell carcinoma, nine were basal cell carcinoma, and a single case of sebaceous cell carcinoma. The median depth of invasion was 4 mm, and the median catheter-to-surface distance was 1 mm. The complete response rate among the 10 definitive cases was 90% and partial response in one case. The treatment was well-tolerated with no grade 3-5 toxicities. The median V95% and V90% were 94.8% and 97.1%, respectively. The mean coverage index (C.I.), dose non-uniformity ratio (DNR), and overdose volume index (ODI) were 0.97, 0.13, and 0.05, respectively. After a median follow-up of 12 months, none of the patients had recurrence. On assessment of DLQI, the scores were found to be significant in association with the tumor size and tumor site with scores favoring <2 cm and non-exposed area lesions. SMBT is a safe and effective treatment modality for skin tumors providing excellent response and cosmetic outcomes. It is well-tolerated and a non-invasive option for elderly patients with comorbidities and lesions in inoperable areas.
Identifiants
pubmed: 39023600
doi: 10.4103/jcrt.jcrt_2641_22
pii: 01363817-202420030-00032
doi:
Substances chimiques
Iridium Radioisotopes
0
Iridium-192
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
930-934Informations de copyright
Copyright © 2024 Copyright: © 2024 Journal of Cancer Research and Therapeutics.
Références
Alam M, Nanda S, Mittal BB, Kim NA, Yoo S. The use of brachytherapy in the treatment of nonmelanoma skin cancer:A review. J Am Acad Dermatol 2011;65:377–88.
Khullar G, Saikia UN, De D, Radotra BD. Nonmelanoma skin cancers:An Indian perspective. Indian J Dermatopathol Diagn Dermatol 2014;1:55–62.
Guix B, Finestres F, Tello J-I, Palma C, Martinez A, Guix JR, et al. Treatment of skin carcinomas of the face by high-dose-rate brachytherapy and custom-made surface molds. Int J Radiat Oncol Biol Phys 2000;47:95–102.
Bath-Hextall F, Bong J, Perkins W, Williams H. Interventions for basal cell carcinoma of the skin:Systematic review. BMJ 2004;329:705–8.
Chen A, Fu J, Grekin R, Margolis L. Cancer of the skin Hoppe R, Phillips T, Roach M. Leibel and Phillips Textbook of Radiation Oncology 3rd ed. Philadelphia, PA: Elsevier; 2010:1439–58.
Drucker AM, Adam GP, Rofeberg V, Gazula A, Smith B, Moustafa F, et al. Treatments of primary basal cell carcinoma of the skin:A systematic review and network meta-analysis. Ann Intern Med 2018;169:456–66.
Kalaghchi B, Esmati E, Ghalehtaki R, Gomar M, Jaberi R, Gholami S, et al. High-dose-rate brachytherapy in treatment of non-melanoma skin cancer of head and neck region:Preliminary results of a prospective single institution study. J Contemp Brachytherapy 2018;10:115–22.
Macfarlane L, Waters A, Evans A, Affleck A, Fleming C. Seven years'experience of Mohs micrographic surgery in a UK centre, and development of a UK minimum dataset and audit standards. Clin Exp Dermatol 2013;38:262–9.
Montero A, Hernanz R, Capuz A-B, Fernández E. High-dose-rate (HDR) plesiotherapy with custom-made moulds for the treatment of non-melanoma skin cancer. Clin Transl Oncol 2009;11:760–4.
Smeets NWJ, Kuijpers DI, Nelemans P, Ostertag JU, Verhaegh MEJM, Krekels GAM, et al. Mohs'micrographic surgery for treatment of basal cell carcinoma of the face - results of a retrospective study and review of the literature. Br J Dermatol 2004;151:141–7.
Arenas M, Arguís M, Díez-Presa L, Henríquez I, Murcia-Mejía M, Gascón M, et al. Hypofractionated high-dose-rate plesiotherapy in nonmelanoma skin cancer treatment. Brachytherapy 2015;14:859–65.
Wilder R, Kittelson J, Shimm D. Basal cell carcinoma treated with radiation therapy. Cancer 1991;68:2134–7.
Lovett R, Perez C, Shapiro S, Garcia D. External irradiation of epithelial skin cancer. Int J Radiat Oncol Biol Phys 1990;19:235–42.
Locke J, Karimpour S, Young G, Lockett M, Perez C. Radiotherapy for epithelial skin cancer. Int J Radiat Oncol Biol Phys 2001;51:748–55.
Mazeron J, Chassagne D, Crook J, Bachelot F, Brochet F, Brune D, et al. Radiation therapy of carcinomas of the skin and nasal vestibule:A report of 1676 cases by the Groupe Europeen de Curiethérapie. Radiother Oncol 1989;13:165–73.
Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)--A simple practical measure for routine clinical use. Clin Exp Dermatol 1994;19:210–6.
Casey S, Awotwi-Pratt J, Bahl G. Surface mould brachytherapy for skin cancers:The British Columbia cancer experience. Cureus 2019;11:e6412.
Rhee JS, Matthews BA, Neuburg M, Logan BR, Burzynski M, Nattinger AB. Validation of a quality-of-life instrument for patients with nonmelanoma skin cancer. Arch Facial Plast Surg 2006;8:314–8.
Gauden R, Pracy M, Avery A-M, Hodgetts I, Gauden S. HDR brachytherapy for superficial non-melanoma skin cancers. J Med Imaging Radiat Oncol 2013;57:212–7.
Svoboda VHJ, Kovarik J, Morris F. High dose-rate microselectron molds in the treatment of skin tumors. Int J Radiat Oncol Biol Phys 1995;31:967–72.
Guinot JL, Rembielak A, Perez-Calatayud J, Rodríguez-Villalba S, Skowronek J, Tagliaferri L, et al. GEC ESTRO. GEC-ESTRO ACROP recommendations in skin brachytherapy. Radiother Oncol 2018;126:377–85.
Köhler-Brock A, Prager W, Pohlmann S, Kunze S. The indications for and results of HDR after loading therapy in diseases of the skin and mucosa with standardized surface applicators (the Leipzig applicator). Strahlenther Onkol 1999;175:170–4.
Ozyar E, Gurdalli S. Mold brachytherapy can be an optional technique for total scalp irradiation. Int J Radiat Oncol Biol Phys 2002;54:1286.
Semrau S, Kunz M, Baggesen K, Vogel H, Buchmann W, Gross G, et al. Successful treatment of field cancerization of the scalp by surface mould brachytherapy. Br J Dermatol 2008;159:753–5.
Kanikowski M. HDR brachytherapy of skin cancer in material of greater Poland cancer center. J Contemp Brachytherapy 2009;1:197.
Skowronek J, Chichel A, Priotrowski T. HDR brachytherapy of skin cancer - the Wielkopolski Cancer Centre's experience. Wspó?cz Onkol 2005;9:347–54.
Allan E, Stanton A, Pye D, Collins C, Perry L, Filby M, Wilkinson J. Fractionated high dose rate brachytherapy moulds—A precise treatment for carcinoma of the pinna. Radiother Oncol 1998;48:277–81.
Somanchi BV, Stanton A, Webb M, Loncaster J, Allan E, Muir LTSW. Hand function after high dose rate brachytherapy for squamous cell carcinoma of the skin of the hand. Clin Oncol 2008;20:691–7.
Brovchuk S, Park SJ, Shepil Z, Romanenko S, Vaskevych O. High-dose-rate skin brachytherapy with interstitial, surface, or a combination of interstitial and surface mold technique. J Contemp Brachytherapy 2022;14:107–14.
Olek D Jr, El-Ghamry MN, Deb N, Thawani N, Shaver C, Mutyala S. Custom mold applicator high-dose-rate brachytherapy for nonmelanoma skin cancer-An analysis of 273 lesions. Brachytherapy 2018;17:601–8.