High-Dose–Rate Brachytherapy for Non-Melanoma Skin Cancer
Posted: Wednesday, May 5, 2021
High-dose–rate brachytherapy with iridium-192 (Ir-192) applied using custom-made surface molds seems safe, effective, and well tolerated in patients with non-melanoma skin cancer, according to a small single-center study. Fabiola Paiar, MD, of the University of Pisa, Italy, and colleagues published their results in Contemporary Oncology.
“Surface mold high-dose–rate brachytherapy,” the authors wrote, “can be considered a good alternative, especially for elderly patients who are often unfit for surgery.”
The study included 37 patients aged 31 to 91 (median age, 79). Nearly two-thirds of patients had basal cell carcinoma, and the others had squamous cell carcinoma. Their lesions, 40 in total, with a depth of no more than 5 mm, were located on the scalp (16), face (10), nose (7), and ear (7). The authors made a custom surface mold of each patient’s skin, with a median of five catheters spaced 5 to 10 mm apart. Then patients received high-dose–rate brachytherapy with Ir-192.
The median follow-up was 25 months, and the range was from 3 to 70 months. The 2-year local control rate was 90%. However, according to the authors, four patients with a partial response died of disease, and 15 other patients died of old age or comorbidities. No patient had to stop treatment for toxicity, and no grade 3 or higher toxicities, either acute or late, were observed. Only one patient had a poor cosmetic result. All other patients’ results were reported to be excellent or good.
Its small size limits the study. The authors also noted that most late toxicity events would only show up with longer follow-up than was possible with mostly elderly patients.
Disclosure: The study authors reported no conflicts of interest.