Electronic Brachytherapy for Basal Cell or Squamous Cell Carcinoma
Posted: Friday, November 5, 2021
A report published in the Journal of Contemporary Brachytherapy (the official journal of the Polish Brachytherapy Society) suggested that high-dose–rate electronic brachytherapy may provide an alternative option for patients with non-melanoma skin cancer who may not be eligible to receive standard surgical approaches for treatment due to comorbidities or lesion locations. Baldassare Stea, MD, PhD, of the University of Arizona, Tucson, and colleagues observed responses in all treated sites after long-term follow-up. However, clinicians should be cautious when electronic brachytherapy is applied to lesions in extremity sites, especially among elderly patients, to avoid toxicities. Additional long-term follow-up is encouraged for this technology to evaluate local control, cosmesis, and late toxicity.
The research team retrospectively conducted chart reviews of 33 patients with non-melanoma skin cancer treated with high-dose–rate electronic brachytherapy between April 2011 and April 2013. A total of 50 cutaneous lesions were treated, including 17 extremity lesions and 33 head and neck lesions.
After treatment, nine of the lesions (18%) developed acute grade 3 moist desquamation. Lesions in the lower extremity (n = 3) and upper lip (n = 1) developed acute grade 4 ulceration. However, the toxicities appeared to improve after a median of 20 days. The study team observed a higher proportion of grade 4 toxicities among patients with lower extremities lesions than patients with head and neck lesions (75% vs. 25%, respectively).
No significant difference was observed in the rate of grade 3 or 4 toxicities between patients older and younger than age 75 (P = .08). After a mean long-term follow-up of 45.6 months, a single local recurrence was reported. It was treated with surgery, and no late toxicities were observed.
Disclosure: The study authors reported no conflicts of interest.