Session Item

Skin high dose rate brachytherapy is an effective treatment for the management of cutaneous metastases of cancers or for primary cutaneous cancers. There is limited literature in terms of survival and safety data.This is why we propose an analysis of the different cases treated at the University Hospital of Limoges.

We collected data from lesions treated with high dose rate brachytherapy from December 2000 to February 2019, within the University Hospital of Limoges. We analyzed survival data (local recurrence) as well as tolerance data (overall acute toxicities, grade I-II and grade III and grade IV) within the overall population as well as within 2 subgroups (primary skin cancers and skin metastases). We analysed the correlation of histology and gender  with toxicity data.

We collected data from 127 skin lesions.

All cancers combined, there was 7% local recurrence in the treatment field out of 13% local recurrence. Sixty-two lesions had a complete response after treatment (49%). Thirty-nine percent of patients presented acute cutaneous toxicities (radio-epithelitis) with 35% of grade I-II, 1.5% of grade III and 0.08% of grade IV.

Fifty-six lesions treated were skin cancers. Fifty percent of this patients presented toxicities with exclusively grade I-II toxicities. In Basal cell carcinoma (32 lesions), we have noted 47% of toxicities with exclusively grade I-II. In carcinoma epidermoid (15 lesions), we found 53% of toxicities with exclusively grade I-II.

Seventy lesions treated were skin metastasis. Thirty-one percent of patients presented toxicities with 24% of grade I-II, 3% of grade III and 1,4% grade IV toxicities (necrosis). In melanoma metastasis (23 lesions), we have noted 30% grade I-II, 4% grade III. In others metastasis (47 lesions), we found 21% grade I-II, 2% grade III and 2% grade IV.

Analyses showed no correlation between gender or tumor histology and the occurrence or grade of acute toxicities, with r correlation coefficients at 0.00 (p=1).

High dose rate brachytherapy is a technique that combines effectiveness with a good local control rate and good clinical tolerance. The results are comparable whether the treatment is for a skin cancer or a cutaneous metastasis.