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. 2017 Dec;9(6):535-539.
doi: 10.5114/jcb.2017.72358. Epub 2017 Dec 30.

The feasibility of using ultrasound during follow-up for superficial non-melanoma skin cancers after electronic brachytherapy

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The feasibility of using ultrasound during follow-up for superficial non-melanoma skin cancers after electronic brachytherapy

Uma Goyal et al. J Contemp Brachytherapy. 2017 Dec.

Abstract

Purpose: Non-melanoma skin cancers (NMSCs) can be treated with a number of modalities including surgery, topical chemotherapy, or radiotherapy. Amongst the radiotherapeutic options, electronic brachytherapy (eBT) is an appealing treatment as it is usually given in a few fractions, it leads to good outcomes, and is increasingly being used. However, currently no follow-up imaging is routinely used or recommended to evaluate treatment response of NMSC. We aimed to use ultrasound (US) in follow-up after eBT for superficial NMSC to assess its feasibility in detecting possible tumor response.

Material and methods: Fourteen patients were treated between 2013-2015 for a NMSC using eBT. US guidance was used for treatment planning prior to eBT initiation. After completion of eBT, patients were seen in follow-up for both clinical exam and a repeat US at 1 month to evaluate if tumor response was detectable.

Results: Of the 14 patients, 6 were male and 8 were female. The mean age was 71 years. With a median follow-up of 20.5 months, all patients had a complete response based on physical exam. Eleven patients appeared to have a complete response based on US obtained > 1 month after completing eBT. To date, there have been no local recurrences or progression, and all patients are alive.

Conclusions: US is an objective imaging modality that may be able to assess NMSC response after eBT. Based on follow-up imaging, further treatment or observation may be recommended. Although this study is hypothesis generating, larger studies with pathologic confirmation of recurrences would be needed to validate US use for follow-up, avoiding possible painful and scarring biopsies in case of low suspicion of recurrence.

Keywords: brachytherapy; electronic; skin cancer; ultrasound.

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Figures

Fig. 1
Fig. 1
Pre- and post-treatment ultrasound imaging. A) Pre-treatment ultrasound imaging shows the depth and diameter of a hypoechoic right nasal ala non-melanoma skin cancers (white crosses). B) Post-treatment ultrasound imaging shows no evidence of residual tumor along the right nasal ala. C) Pre-treatment ultrasound imaging shows a hypoechoic lesion on the left nasal ala measuring 0.69 cm in diameter and 0.26 cm in depth (white crosses). D) Post-treatment ultrasound 6 months later demonstrates interval reduction in size of the same lesion, now measuring 0.50 cm in diameter and 0.21 cm in depth consistent with a partial response

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