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Superficial Brachytherapy for Skin Cancer Lesions on Lower Limbs: Case Report

By: Kelly M. Hennessey, PhD
Posted: Monday, January 4, 2021

Treatment of basal cell carcinoma in areas of poor vascularization in elderly and frail individuals can be difficult because of risks, prolonged healing, and tissue damage associated with surgery and other methods of treatment. Brachytherapy provides a radiation treatment option for patients with cancerous lesions over curved surfaces such as bones, cartilage, or tendons, when surgery and traditional therapies are less safe. Agata Rembielak, BSc, MD, PhD, of the Christie NHS Foundation Trust and The University of Manchester, UK, presented a case study on the use of superficial brachytherapy for a patient with basal cell carcinoma affecting her right shin. The results of the study were published in the Journal of Contemporary Brachytherapy.

An 84-year-old woman presented with a nonhealing lesion on her right anterior shin. Clinical examination detected a 1.6 cm x 1.3 cm lesion approximately 2.56 mm thick. Due to a history of varicose veins, she opted for superficial high-dose–rate brachytherapy. She received 37.5 Gy to 80% delivered in eight fractions, twice a day over 4 consecutive days. No skin reactions were noted during or immediately after treatment.

Six weeks post-treatment, she presented with a skin infection and was treated with antibiotics. At the end of 2 weeks, her skin wound was weepy with fragile surrounding skin; she was symptomatic and in significant pain. Her wound was cleaned, and she was prescribed oral painkillers. Three days later, she presented with a large odorous wound measuring 6 cm x 4 cm with visible necrotic masses; anaerobic growth was confirmed, and she was prescribed oral metronidazole. After 7 days, there was no odor present, and her condition had improved.

Over the next 10 months, she was routinely monitored and received regular wound cleaning and desloughing. She was evaluated 15 months post-brachytherapy; her wound had healed and remained completely healed at the time of publication. 

Disclosure: The study authors reported no conflicts of interest.



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