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Definitive HDR Brachytherapy for Non-Melanoma Skin Cancer

By: Alison Tewksbury
Posted: Monday, December 3, 2018

The results of data analysis from 60 patients treated for non-melanoma skin cancers were presented in a poster at the 2018 American Society for Radiation Oncology (ASTRO) Annual Meeting by Courtney Hentz, MD, of Loyola University Medical Center, Maywood, Illinois, and colleagues (Abstract MO_24_2576). Their findings show that definitive high-dose–rate (HDR) brachytherapy appears to be a viable treatment option for this patient population, with “excellent local control, low toxicity, and overall great patient-reported and physician-graded cosmesis.” Further studies comparing this approach with surgery and external-beam radiation therapy are underway at the investigators’ institution.

Since 2015, data were recorded from 61 patients who received treatment with HDR brachytherapy for 80 non-melanoma skin lesions; physician-graded and patient follow up data were also tracked. The most common treatment protocol was 32 to 40 Gy in 8 to 10 fractions twice weekly. The most common histology treated was basal cell carcinoma (52%), followed by squamous cell carcinoma (35%).

At a median follow-up of 12 months, the local disease control rate was 97.3%. Early grade 2 adverse events were reported in 5.6% of patients, and grade 3 physician-graded skin toxicities were noted in 2.8% of patients. Late grade 2 side effects occurred in 1.3%, and no grade 4 toxicities were reported. Patient-reported cosmesis was good to excellent in more than 92% in both early and follow-up FU. The only patient characteristic associated with a higher risk for less-than-good cosmetic outcome at early follow was being a smoker.

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