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. 2015 Jun;7(3):231-8.
doi: 10.5114/jcb.2015.52140. Epub 2015 Jun 9.

Efficacy and safety of electronic brachytherapy for superficial and nodular basal cell carcinoma

Rosa Ballester-Sánchez  1 , Olga Pons-Llanas  2 , Cristian Candela-Juan  3 , Francisco Javier Celada-Alvarez  2 , Blanca de Unamuno-Bustos  1 , Margarita Llavador-Ros  4 , Antonio Ballesta-Cuñat  5 , Christopher A Barker  6 , Alejandro Tormo-Mico  2 , Rafael Botella-Estrada  1 , Jose Perez-Calatayud  3
Affiliations

Efficacy and safety of electronic brachytherapy for superficial and nodular basal cell carcinoma

Rosa Ballester-Sánchez et al. J Contemp Brachytherapy. 2015 Jun.

Abstract

Purpose: Surface electronic brachytherapy (EBT) is an alternative radiotherapy solution to external beam electron radiotherapy and high-dose-rate radionuclide-based brachytherapy. In fact, it is also an alternative solution to surgery for a subgroup of patients. The objective of this work is to confirm the clinical efficacy, toxicity and cosmesis of a new EBT system, namely Esteya(®) in the treatment of nodular and superficial basal cell carcinoma (BCC).

Material and methods: This is a prospective single-center, non-randomized pilot study to assess the efficacy and safety of EBT in nodular and superficial BCC using the Esteya(®) system. The study was conducted from June 2014 to February 2015. The follow up time was 6 months for all cases.

Results: Twenty patients with 23 lesions were included. A complete response was documented in all lesions (100%). A low level of toxicity was observed after the 4(th) fraction in all cases. Erythema was the most frequent adverse event. Cosmesis was excellent, with more than 60% of cases without skin alteration and with subtle changes in the rest.

Conclusions: Electronic brachytherapy with Esteya(®) appears to be an effective, simple, safe, and comfortable treatment for nodular and superficial BCC associated with excellent cosmesis. It could be a good choice for elderly patients, patients with contraindications for surgery (due to comorbidities or anticoagulant drugs) or patients where surgery would result in a more disfiguring outcome. A longer follow-up and more studies are needed to confirm these preliminary results.

Keywords: basal cell carcinoma; electronic brachytherapy; skin brachytherapy; skin cancer.

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Figures

Fig. 1
Fig. 1
A) Tumor marking with template La Fe. B) Marks delimiting tumor margin (in red) and the external mark (in blue) to fit the applicator in the center
Fig. 2
Fig. 2
The Esteya® arm has several degrees of freedom in order to place the applicator
Fig. 3
Fig. 3
A) Superficial basal cell carcinoma located on the scalp prior to treatment. B) Two weeks after last electronic brachytherapy (EBT) fraction. C) Three months after last EBT fraction. D) Six months after last EBT fraction
Fig. 4
Fig. 4
A) Superficial basal cell carcinoma located on the cheek prior to treatment. B) Two weeks after last EBT fraction. C) Three months after last EBT fraction. D) Six months after last EBT fraction
See this image and copyright information in PMC

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