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Soo Park, MD
Soo Park, MD
Posted: Tuesday, November 15, 2022
High–dose rate (HDR) brachytherapy custom thermoplastic applicators may prove to be a safe and effective means of treating patients with non-melanoma skin cancers located on the face, according to a study presented at the 2022 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 2727). Jason Naziri, MD, of Baylor Scott and White Health, Temple, Texas, and colleagues reported on this “underutilized modality of radiation treatment....”
A total of 301 cutaneous carcinomas of the face were treated in the study. Most lesions were identified as basal cell carcinomas located on the nose (33.9%), cheek (20.9%), forehead (18.6%), and ear (17.3%). The mean tumor size was 1.4 cm. Treatment consisted of HDR brachytherapy iridium-192 custom thermoplastic applicators. The authors reported that hypofractionated radiation regimens were given as 40 Gy in eight fractions twice weekly or 48 Gy in 16 fractions four times weekly.
The authors reported a rate of local tumor control of 95.7%, with recurrences salvaged by irradiation in either wide local excision (30.7%) or Moh’s micrographic surgery (23.1%). Median follow-up was 28.2 months (range, 1–149 months).
In terms of toxicity, the authors reported grade 0 or 1 acute radiation dermatitis in 66.1% of lesions, grade 2 acute radiation dermatitis in 27.4%, grade 3 acute radiation dermatitis in 6.2%, and grade 4 acute radiation dermatitis in one patient. There were no reported chronic ulcers, which the study authors believe support the safe use of HDR brachytherapy custom thermoplastic applicators for non-melanoma skin cancers.
Disclosure: Dr. Naziri reported no conflicts of interest.
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