HDR brachytherapy with individual epithetic molds for facial skin cancer: techniques and first clinical experience
Background Facial skin cancer lesions in close proximity to critical organs require further development of radiotherapeutic techniques for highly conformal treatment, especially when treating elderly frail patients. We report on our treatment technique and first clinical experience for patients with...
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| Published in: | International journal of dermatology Vol. 60; no. 6; pp. 717 - 723 |
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| Main Authors: | , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
Blackwell Publishing Ltd
01-06-2021
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| Abstract | Background
Facial skin cancer lesions in close proximity to critical organs require further development of radiotherapeutic techniques for highly conformal treatment, especially when treating elderly frail patients. We report on our treatment technique and first clinical experience for patients with perinasal/periorbital skin cancer treated with individualized epithetic mold high‐dose‐rate brachytherapy (BRT).
Methods
From January 2019, patients with complex shaped or unfavorably located skin cancer not eligible for surgery or external beam radiotherapy (RT) were screened for mold‐based BRT. Six patients were identified. Toxicity and clinical response were documented during therapy and posttreatment follow‐up.
Results
Median patient age was 80 years (74–92 years). Median prescription dose was 42 Gy (range, 33–44 Gy) delivered in once‐daily fractions of 3 or 4 Gy. Two patients had treatment interruptions caused by acute conjunctivitis grade 2 and a nontreatment‐related cardiac event, respectively. At a median follow‐up of 335 days (96–628 days), no ≥ grade 2 late toxicity was documented with all patients showing complete clinical response.
Conclusions
High‐dose‐rate BRT with individualized epithetic molds for perinasal/periorbital skin cancer is a well‐tolerated and safe treatment option for patients not eligible for primary surgery or definitive external beam RT because of comorbidities or tumor location. |
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| AbstractList | Background
Facial skin cancer lesions in close proximity to critical organs require further development of radiotherapeutic techniques for highly conformal treatment, especially when treating elderly frail patients. We report on our treatment technique and first clinical experience for patients with perinasal/periorbital skin cancer treated with individualized epithetic mold high‐dose‐rate brachytherapy (BRT).
Methods
From January 2019, patients with complex shaped or unfavorably located skin cancer not eligible for surgery or external beam radiotherapy (RT) were screened for mold‐based BRT. Six patients were identified. Toxicity and clinical response were documented during therapy and posttreatment follow‐up.
Results
Median patient age was 80 years (74–92 years). Median prescription dose was 42 Gy (range, 33–44 Gy) delivered in once‐daily fractions of 3 or 4 Gy. Two patients had treatment interruptions caused by acute conjunctivitis grade 2 and a nontreatment‐related cardiac event, respectively. At a median follow‐up of 335 days (96–628 days), no ≥ grade 2 late toxicity was documented with all patients showing complete clinical response.
Conclusions
High‐dose‐rate BRT with individualized epithetic molds for perinasal/periorbital skin cancer is a well‐tolerated and safe treatment option for patients not eligible for primary surgery or definitive external beam RT because of comorbidities or tumor location. Facial skin cancer lesions in close proximity to critical organs require further development of radiotherapeutic techniques for highly conformal treatment, especially when treating elderly frail patients. We report on our treatment technique and first clinical experience for patients with perinasal/periorbital skin cancer treated with individualized epithetic mold high-dose-rate brachytherapy (BRT). From January 2019, patients with complex shaped or unfavorably located skin cancer not eligible for surgery or external beam radiotherapy (RT) were screened for mold-based BRT. Six patients were identified. Toxicity and clinical response were documented during therapy and posttreatment follow-up. Median patient age was 80 years (74-92 years). Median prescription dose was 42 Gy (range, 33-44 Gy) delivered in once-daily fractions of 3 or 4 Gy. Two patients had treatment interruptions caused by acute conjunctivitis grade 2 and a nontreatment-related cardiac event, respectively. At a median follow-up of 335 days (96-628 days), no ≥ grade 2 late toxicity was documented with all patients showing complete clinical response. High-dose-rate BRT with individualized epithetic molds for perinasal/periorbital skin cancer is a well-tolerated and safe treatment option for patients not eligible for primary surgery or definitive external beam RT because of comorbidities or tumor location. BACKGROUNDFacial skin cancer lesions in close proximity to critical organs require further development of radiotherapeutic techniques for highly conformal treatment, especially when treating elderly frail patients. We report on our treatment technique and first clinical experience for patients with perinasal/periorbital skin cancer treated with individualized epithetic mold high-dose-rate brachytherapy (BRT). METHODSFrom January 2019, patients with complex shaped or unfavorably located skin cancer not eligible for surgery or external beam radiotherapy (RT) were screened for mold-based BRT. Six patients were identified. Toxicity and clinical response were documented during therapy and posttreatment follow-up. RESULTSMedian patient age was 80 years (74-92 years). Median prescription dose was 42 Gy (range, 33-44 Gy) delivered in once-daily fractions of 3 or 4 Gy. Two patients had treatment interruptions caused by acute conjunctivitis grade 2 and a nontreatment-related cardiac event, respectively. At a median follow-up of 335 days (96-628 days), no ≥ grade 2 late toxicity was documented with all patients showing complete clinical response. CONCLUSIONSHigh-dose-rate BRT with individualized epithetic molds for perinasal/periorbital skin cancer is a well-tolerated and safe treatment option for patients not eligible for primary surgery or definitive external beam RT because of comorbidities or tumor location. |
| Author | Diefenhardt, Markus Chatzikonstantinou, Georgios Rödel, Claus Ramm, Ulla Tselis, Nikolaos Köhn, Janett Scherf, Christian Trommel, Martin Licher, Jörg Meissner, Markus |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33638418$$D View this record in MEDLINE/PubMed |
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| Copyright | 2021 The Authors. published by Wiley Periodicals LLC on behalf of the International Society of Dermatology. 2021 The Authors. International Journal of Dermatology published by Wiley Periodicals LLC on behalf of the International Society of Dermatology. 2021. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| Notes | Authors contributed equally. Access to Data/Data analysis: Drs. Diefenhardt, Chatzikonstantinou, and Tselis had full access to all the data in the study and take responsibility for the integrity and accuracy of the data analysis. Conflict of interest: None. Funding source: Projekt DEAL ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
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Facial skin cancer lesions in close proximity to critical organs require further development of radiotherapeutic techniques for highly conformal... Facial skin cancer lesions in close proximity to critical organs require further development of radiotherapeutic techniques for highly conformal treatment,... BackgroundFacial skin cancer lesions in close proximity to critical organs require further development of radiotherapeutic techniques for highly conformal... BACKGROUNDFacial skin cancer lesions in close proximity to critical organs require further development of radiotherapeutic techniques for highly conformal... |
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| SubjectTerms | Brachytherapy Cancer Conjunctivitis Dosage Molds Organs Patients Radiation dosage Radiation therapy Skin cancer Skin diseases Surgery Toxicity |
| Title | HDR brachytherapy with individual epithetic molds for facial skin cancer: techniques and first clinical experience |
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