Treatment of facial cutaneous carcinoma with high-dose rate contact brachytherapy with customized molds

Brachytherapy. 2011 May-Jun;10(3):221-7. doi: 10.1016/j.brachy.2010.08.005. Epub 2010 Oct 8.

Abstract

Background: The main treatment given for initial stage facial epitheliomas is surgery, although there are alternatives. We present our results with Ir-192 high-dose rate (HDR) contact brachytherapy.

Methods and materials: Fifty-one epitheliomas, with a mean size of 1.5 cm and a maximum thickness of 3mm, were treated with HDR contact brachytherapy by means of customized molds, with plastic tubes on bolus for flat surfaces and on wax molds for the nose. A total dose of 48-57 Gy, 3-4 Gy/fraction three times a week, was administered.

Results: After a median followup of 45 months, five tumors relapsed (9.8%), four of them on the tip of the nose. The 5-year actuarial local control rate was 89%, 100% for flat surfaces, and 83% for the nose. All of them were salvaged with surgery. The treatment was well tolerated, 21.6% developed severe acute toxicity, with good or very good late cosmetic results.

Conclusion: HDR contact brachytherapy is a good alternative to treat facial epitheliomas with a maximum thickness of 3mm. Tip of the nose tumors are not well covered with this technique and a different procedure is required.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brachytherapy / instrumentation*
  • Brachytherapy / methods*
  • Equipment Design
  • Equipment Failure Analysis
  • Facial Neoplasms / radiotherapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Skin Neoplasms / radiotherapy*
  • Treatment Outcome