Head and Neck Cancers Coverage from Every Angle
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RSNA 2019: Brachytherapy for Elderly Patients With Skin Cancer of the Head/Neck

By: Melissa E. Fryman, MS
Posted: Thursday, December 19, 2019

High-dose–rate brachytherapy seems to be effective in older patients with early-stage non-melanoma skin cancer of the head and neck, according to Ashwatha Narayana, MD, of Northern Westchester Hospital, New York, and colleagues. This type of therapy, as an alternative to Mohs surgery, is well recognized but tends to be underutilized. Their findings were presented at the 2019 Radiological Society of North America (RSNA) Scientific Assembly and Annual Meeting in Chicago (Abstract SSM24-02).

“Treatment with external-beam radiation therapy can be too long and painful for elderly patients,” said Dr. Narayana in an RSNA press release. “It also exposes healthy tissue around the lesion to radiation, which can increase side effects. Brachytherapy delivers a higher dose of radiation directly to the tumor while sparing healthy tissue nearby.”

In this single-center case series study, a total of 70 patients with early-stage basal and squamous cell carcinoma in the head, neck, or leg areas were treated with high-dose–rate brachytherapy using customized superficial mold applicators. The median age of patients in this study was 85.

After a median follow-up of 24 months, the rates of local control for basal cell carcinoma and squamous cell carcinoma were 98% and 96%, respectively. Cosmetic outcomes were “excellent” in 90% of patients. Two patients experienced recurrences at 3 and 6 months after therapy; both cases involved the lower extremities. Minor late effects in less than 10% of patients included hypopigmentation, hyperpigmentation, telangiectasia, and atrophy of the skin.

“High-dose–rate brachytherapy is a powerful way of treating skin cancers in both elderly and younger patients,” concluded Dr. Narayana. This study, and others like it, may raise awareness of this treatment for patients with non-melanoma skin cancer in the future.

Disclosure: For disclosures of the study authors, visit meeting.rsna.org.

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