Therapeutic possibilities in the radiation treatment of NMSC: brachytherapy vs. electrons therapy
Carlos Camacho Fuentes,
Spain
PO-1812
Abstract
Therapeutic possibilities in the radiation treatment of NMSC: brachytherapy vs. electrons therapy
Authors: Carlos Camacho Fuentes1, Carla Sánchez Cortés1, María Calderó Torra1, María Luisa Ferrández Millán1, Marina Gascón Ferrer1, Luis Sopeña Sanz1
1Lozano Blesa Clinical Universitary Hospital, Radiation Oncology, Zaragoza, Spain
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Purpose or Objective
The incidence of skin
cancer has been increasing in recent decades, with an estimated 2-3 million
non-melanoma skin cancer (NMSC) occurring annually globally. There are different
treatment modalities for this pathology, with brachytherapy (BT) playing a
fundamental role. The main objective of this work is to compare the toxicity profile, aesthetic results and local control of patients with non-melanoma skin cancer treated with skin brachytherapy with Leipzig applicator versus those treated with electron therapy (ET) at the Lozano Blesa Clinical Universitary Hospital.
Material and Methods
A retrospective-comparative study where demographic, tumor, treatment and toxicity characteristics of 22 patients treated with BT at 42Gy/7fx and 24 treated with ET at 45-55Gy/9-11fx from June/2020 to June/2021 were collected and analyzed.
Table
1. ASTRO
indications for radiation therapy in NMSC. |
|
|
Type
of
treatment | Histology | Indications
|
| Radical | BCC
and SCC | Patients
who
cannot undergo or decline surgical resection.
Patients with tumors in anatomic locations where surgery can compromise function or cosmesis. |
| Adjuvant | BCC
and SCC | For
groos
perineural spread that is clinically or radiologically apparent.
Close
or
positive margins that cannot be corrected with further surgery (secondary to morbidity or adverse cosmetic outcome).
In the setting of recurrence
after a prior margin-negative
resection. |
| BCC
| Locally advanced or neglected tumors involving bone or infiltrating into muscle. |
| SCC
| T3 and T4 tumors.
For
desmoplastic or infiltrative tumors
in the
setting of chronic immunosuppression. |
Results
Median follow-up was 8 months (range 3-11). 21 patients received treatment with radical intention and 24 as adjuvant. Median age was 77.5 years (57.8% were male). In terms of histology, 53.3% were squamous cell carcinomas and 46.7% basal cell carcinomas. The most frequently treated site was frontoparietal (35.6%). The most frequent collimator diameters used in BT were 45 and 30mm. Of those treated with BT, 66.7% presented acute toxicity (42.9% G-I and 28.6 G-II) and 46.6% chronic toxicity, compared to 100% (62.5% G-I and 33.3% G-II) (p=0.011) and 50% of those treated with ET, respectively. A total of 86.7% obtained excellent aesthetic results with BT and 75% with ET. 100% obtained a complete response at 90 days. There were no recurrences and only one death occurred due to non-tumor causes.
Conclusion
With equal effectiveness in the treatment of NMSC, BT with Leipzig applicators appears to have better acute toxicity profiles than ET.