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Non-melanoma skin cancer (NMSC) is one of the most frequent skin tumors, being its most frequent diagnosis in elderly patients. The mortality rate of this type of tumor is low, but nevertheless, it can be associated with great morbidity in terms of cosmetic and functional results. Surgical treatment is now considered the standard, but its approach may not be suitable for all patients. High-dose brachytherapy (BT-HDR) has achieved good rates of local control and aesthetic results. Within this treatment modality, plesiotherapy using individualized molds is presented as a safe and comfortable option, especially in elderly patients. We present the results in terms of local control (LC), aesthetic results and toxicity in patients with NMSC treated with BT-HDR, plesiotherapy modality; with radical or adjuvant intention.

Retrospective study of 194 pts with 246 NMSC lesions, stage T1 (78.9%) and T2 (21.1%) in treatment from May 2015 to May 2017. BT-HDR treatment (6 Gy / fraction, total dose 42 Gy) was used in 88.2% patients with an equivalent dose of 2 Gy (EQD2) of 56 Gy. All lesions were limited in depth of 3-4 mm. The median age was 79 years (range 29-97), being 61.4% men and 38.6% women. Basal cell carcinoma (85.8%) was the most frequent histological type. 39.1% of the lesions were treated with Valencia applicators and 42.7% with individualized handmade molds.

The LC was 95.1%. Of the 246 lesions treated, 12 presented relapse in the treatment field (4.88%). There were no differences in terms of CL related to the type of applicator used (p 0.910) and neither with stage T (p 0.149). Most of the patients had grade 1-2 acute skin toxicity. Conjunctival toxicity appeared in 8.9% of the patients (22 patients). Cosmetic results were considered excellent / very good in all patients. In the cosmetic result, pigmentation changes, the appearance or not of alopecia, ulceration or edema, and the appearance of telangiectasia were evaluated.

Plesiotherapy treatment is a good treatment alternative that provides excellent local control results and in aesthetic terms (similar to the main BT-HDR studies). It also facilitates compliance with treatment thanks to its comfort and good tolerance, which is very important in elderly patients. BT-HDR is a safe and attractive treatment option for non-surgical patients or when cosmetic results are not good after surgery that must be taken into account when treating these types of injuries.