Vienna, Austria

ESTRO 2023

Session Item

Brachytherapy: Head and neck, skin, eye
7018
Poster (Digital)
Brachytherapy
High dose rate surface brachytherapy in non-melanoma skin cancer
Sandra Fernandez Alonso, Spain
PO-2188

Abstract

High dose rate surface brachytherapy in non-melanoma skin cancer
Authors:

Claudia F. Pedrero1, Sandra Fernandez Alonso1, Sandra Guardado González1, Cristian Arias Guillén1, Gustavo Pozo Rodriguez2, Enrique Capón Saez1, Alejandro Ferrando Sanchez2, Rafael D´Ambrosi1, José Fermín Pérez-Regadera Gómez1

1Hospital Universitario 12 de Octubre, Radiation Oncology, Madrid, Spain; 2Hospital Universitario 12 de Octubre, Medical Physicist, Madrid, Spain

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Purpose or Objective

To study the evolution of patients diagnosed by non-melanoma skin cancer treated by HDR plesiotherapy in our center.

Material and Methods

Between 01/01/17 and 08/30/22, 37 patients were treated and we studied retrospectively their characteristics.

All lesions were staged following the 8th TNM-UICC system and to assess toxicity, we used the CTCAE v5.0 scales.

Results

Mean age was 76 years (range 67-93). 70% were men and 30% women.

The histology was squamous cell in 49%, basal cell in 43% and others in 7%.

According to the 8th TNM-UICC staging, 11% was T1N0M0, 70% was T2N0M0, 11% was T3N0M0, 3% was T3N1M0, 3% T3N2M0 and 2% was T4N0M0.

51% patients had undergone prior surgery on the lesion.

Lesions were located in the ear in 66% cases, in the nose in 9%, in temporal region in 6%, in frontal region in 6%, in the lip in 6%, in the periorbital region in 3%, in the shell in 2% and in the scrotum in 2%.

Dose were delivered according to the following fractionation schemes: 6x7Gy 63%, 9x4.5Gy 25%, 7x7Gy 3%, 5x7Gy 3%, 5x5Gy 3% 25x2Gy 3%.

G1 skin acute toxicity appeared in 40%, G2 in 25% and G3 in 11%. No G4 acute toxicity was observed.

G1 skin chronic toxicity appeared in 32% (13% hypopigmentation, 8% hyperpigmentation, 5% induration, 3% atrophy and 3% fibrosis).

Median OS was 5 years.

OS according to pathological stage was 3 years in T1, 5 years in T2, less than 2 years in T3 and less than 1 year in T1 stages.

There were statistically significant differences in terms of OS in favor of T1-T2 stages (p=0.061).

At 3 months, complete response (CR) was observed in 77% cases, stable lesion (SL) in 13%, progression (PG) in 7% a partial response (PR) in 3%.

At 6 months, CR was observed in 77% cases, SL in 8%, PG in 12% a PR in 3%.

At 12 months, CR was observed in 67% cases, SL in 13%, PG in 13% a PR in 7%.

Recurrences were observed in 14%, and all of them were treated, 50% with RT and 50% with surgery.

Progression free survival was 81% at 2 years and 69% at 5 years with no differences according to tumor stage (p=0.12).

As October/22, 61% of patients are alive without skin lesion, 14% alive with skin lesion and 25% have died.

The cause of death was unrelated to the skin tumor in 89%.




Conclusion

HDR plesiotherapy is a treatment option for non-melanoma skin cancer in fragile patients due to comorbidity or to avoid aesthetic impact due to scars with good results in local control and toxicity.