Abstract
Purpose Brachytherapy is a well-known treatment in the management of skin tumors. For facial or scalp lesions, applicators have been developed to deliver non-invasive treatment. We present cases treated with customized applicators with high dose rate system. Material and methods Patients with poor performance status treated for malignant skin lesions of the scalp or the facial skin between 2011 and 2014 were studied. Afterloading devices were chosen between Freiburg® Flap, silicone-mold or wax applicators. The clinical target volume (CTV) was created by adding margins to lesions (10 mm to 20 mm). The dose schedules were 25 Gy in five fractions for postoperative lesions, 30 Gy in six fractions for exclusive treatments and a single session of 8 Gy could be considered for palliative treatments. Results In 30 months, 11 patients received a treatment for a total of 12 lesions. The median age was 80 years. The median follow-up was 17 months and the 2-year local control rate was 91%. The mean CTV surface was 41.1 cm2 with a mean thickness of 6.1 mm. We conceived three wax applicators, used our silicone-mold eight times and the Freiburg® Flap one time. We observed only low-grade radiodermitis (grade I: 50%, grade II: 33%), and no high-grade skin toxicity. Conclusion High dose rate brachytherapy with customized applicators for facial skin and scalp lesions is efficient and safe. It is a good modality to treat complex lesions in patients unfit for invasive treatment.
| Original language | English |
|---|---|
| Pages (from-to) | 341-346 |
| Number of pages | 6 |
| Journal | Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique |
| Volume | 20 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 1 Jul 2016 |
| Externally published | Yes |
Keywords
- Customized applicators
- Dose optimization
- HDR brachytherapy
- Local control
- Non-melanoma skin cancer
- Surface molds