Superficial high-dose-rate brachytherapy for primary tumors and relapses after surgery in patients with basal cell carcinoma of the head and neck region: results of a retrospective comparative cohort study

• Published in: Journal of contemporary brachytherapy Vol. 14; no. 5; pp. 438 - 445
• Main Authors: Chyrek, Artur J, Chicheł, Adam, Burchardt, Wojciech M, Bielęda, Grzegorz, Jankowska, Małgorzata, Moczko, Jerzy, Roszak, Andrzej
• Format: Journal Article
• Language: English
• Published: Poland Termedia Publishing House 01-10-2022
• Subjects: bcc; hdr; head and neck; Original Paper; recurrence; skin cancer; recurrence; skin cancer; head and neck; BCC; HDR
• ISSN: 1689-832X; 2081-2841
• DOI: 10.5114/jcb.2022.121134

The recommended treatments for basal cell carcinoma (BCC) in the head and neck (H&N) region are Mohs surgery, standard surgical excision (SSE), and radiotherapy. According to the literature, local recurrence after surgical treatment in this area is associated with a worse prognosis in case of re-treatment. To our knowledge, there are no reports on high-dose-rate brachytherapy (HDR-BT) for BCC of the H&N region, both in primary lesions and relapses after SSE. This study aimed to fill this gap in the literature.
Inclusion criteria were pathologically confirmed BCC, tumor location in the H&N region, treatment performed with superficial HDR-BT, and a minimum follow-up of 12 months. An analysis was performed on a group of 90 patients, in whom a total of 102 tumors were treated. Subsequently, tumors were divided into two sub-groups, including those treated initially, and treated due to local recurrence after previous SSE. Primary treatment group (PrG) included 59 tumors, whereas 43 tumors were included in recurrent group (ReG).
Statistical analysis did not reveal any significant differences between the groups in terms of age (
= 0.43), treatment duration (
= 0.17), follow-up time (
= 0.96), sex (
= 0.18), local advancement (
= 0.83), and location (
= 0.68). The estimated 5-year relapse-free survival was 96.4% in the PrG and 94.6% in the ReG group, and the difference was not statistically significant (
= 0.72). In the PrG, skin toxicity was as follows: early G1 - 20.3%, G2 - 28.8%, G3 - 42.4%, G4 - 8.5%; late G1 - 33.9%, G2 - 50.8%, G3 - 1.7%, G4 - 11.9%. Whereas, in the ReG, toxicity was as follows: early G1 - 16.3%, G2 - 41.9%, G3 - 37.2%, G4 - 4.6%; late G1 - 30.2%, G2 - 62.8%, G3 - 4.6%. There were no statistically significant differences in the early nor late toxicity between the groups (
= 0.54,
= 0.16).
Superficial HDR-BT is a highly effective treatment for both primary and recurrent BCC of the H&N region, and is associated with acceptable skin toxicity.