Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Sep 28:5:87.
doi: 10.1186/1748-717X-5-87.

The initial experience of electronic brachytherapy for the treatment of non-melanoma skin cancer

Ajay Bhatnagar  1 , Alphonse Loper
Affiliations

The initial experience of electronic brachytherapy for the treatment of non-melanoma skin cancer

Ajay Bhatnagar et al. Radiat Oncol. .

Abstract

Background: Millions of people are diagnosed with non-melanoma skin cancers (NMSC) worldwide each year. While surgical approaches are the standard treatment, some patients are appropriate candidates for radiation therapy for NMSC. High dose rate (HDR) brachytherapy using surface applicators has shown efficacy in the treatment of NMSC and shortens the radiation treatment schedule by using a condensed hypofractionated approach. An electronic brachytherapy (EBT) system permits treatment of NMSC without the use of a radioactive isotope.

Methods: Data were collected retrospectively from patients treated from July 2009 through March 2010. Pre-treatment biopsy was performed to confirm a malignant cutaneous diagnosis. A CT scan was performed to assess lesion depth for treatment planning, and an appropriate size of surface applicator was selected to provide an acceptable margin. An HDR EBT system delivered a dose of 40.0 Gy in eight fractions twice weekly with 48 hours between fractions, prescribed to a depth of 3-7 mm. Treatment feasibility, acute safety, efficacy outcomes, and cosmetic results were assessed.

Results: Thirty-seven patients (mean age 72.5 years) with 44 cutaneous malignancies were treated. Of 44 lesions treated, 39 (89%) were T1, 1 (2%) Tis, 1 (2%) T2, and 3 (7%) lesions were recurrent. Lesion locations included the nose for 16 lesions (36.4%), ear 5 (11%), scalp 5 (11%), face 14 (32%), and an extremity for 4 (9%). Median follow-up was 4.1 months. No severe toxicities occurred. Cosmesis ratings were good to excellent for 100% of the lesions at follow-up.

Conclusions: The early outcomes of EBT for the treatment of NMSC appear to show acceptable acute safety and favorable cosmetic outcomes. Using a hypofractionated approach, EBT provides a convenient treatment schedule.

PubMed Disclaimer

Figures

Figure 1
Figure 1
EBT Surface Applicators for Use with the Axxent® System.
Figure 2
Figure 2
Depth Dose Comparison of HDR EBT with HDR 192Iridium.
Figure 3
Figure 3
EBT Source Beam Profile.
Figure 4
Figure 4
EBT Treatment of Basal Cell Carcinoma. Photo at pretreatment (top left), prior to fraction 7 of 8 (top right), at one-month follow up (bottom left), and at six months of follow up (bottom right).
Figure 5
Figure 5
EBT Treatment of Cutaneous T-cell Lymphoma. Photo at pretreatment (left) and at two months of follow up (right).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Rogers HW, Martin A. Incidence Estimate of Nonmelanoma Skin Cancer in the United States, 2006. Arch Dermatol. 2010;146:283–287. doi: 10.1001/archdermatol.2010.19. - DOI - PubMed
    1. Jemal A, Siegel R, Ward E, Hao Y, XU J, Thun M J. Cancer statistics, 2009. CA Cancer J Clin. 2009;59:225–249. doi: 10.3322/caac.20006. - DOI - PubMed
    1. Skin cancer - UK incidence statistics. Cancer Research UK. http://info.cancerresearchuk.org/cancerstats/types/skin/index.htm Accessed June 30, 2010.
    1. Skin Cancer Net. Schaumberg, Illinois: American Academy of Dermatology; http://www.skincarephysicians.com/skincancernet/whatis.html Accessed June 17, 2010.
    1. Barlow JO, Zalla MJ, Kyle A, DiCaudao DJ, Lim KK, Yiannias JA. Treatment of basal cell carcinoma with curettage alone. J Am Acad Dermatol. 2006;54:1034–1039. doi: 10.1016/j.jaad.2006.01.041. - DOI - PubMed