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. 2021 Jan 26;13(3):454.
doi: 10.3390/cancers13030454.

Single-Fraction Adjuvant Electronic Brachytherapy after Resection of Conjunctival Carcinoma

Gustavo R Sarria  1 , Solon Serpa  2 , Mario Buitrago  2 , Paola Fuentes Rivera  3 , Diego Ramirez  2 , Frank A Giordano  1 , Gustavo J Sarria  3
Affiliations

Single-Fraction Adjuvant Electronic Brachytherapy after Resection of Conjunctival Carcinoma

Gustavo R Sarria et al. Cancers (Basel). .

Abstract

A retrospective study was performed to assess the outcomes of a single-fraction adjuvant electronic brachytherapy (e-BT) approach for patients with squamous cell conjunctival carcinoma (SCCC). Forty-seven patients with T1-T3 SCCC were included. All patients underwent surgery followed by a single-fraction adjuvant e-BT with a porTable 50-kV device. Depending on margins, e-BT doses ranged between 18 to 22 Gy prescribed at 2 mm depth, resembling equivalent doses in 2 Gy (EQD2) per fraction of 46-66 Gy (α/β ratio of 8-10 Gy and a relative biological effect (RBE) of 1.3). The median age was 69 (29-87) years. Most tumors were T1 (40.4%) or T2 (57.5%) with a median size of 7 mm (1.5-20). Margins were positive in 40.4% of cases. The median time from surgery to e-BT was nine weeks (0-37). After a median follow-up of 24 (17-40) months, recurrence occurred in only two patients (6 and 7 months after e-BT), yielding a median disease-free survival (DFS) of 24 (6-40) months and DFS at two years of 95.7%. Acute grade 2 conjunctivitis occurred in 25.5%. E-BT is a safe and effective for SCCC treatment, with clinical and logistic advantages compared to classical methods. Longer follow-up and prospective assessment are warranted.

Keywords: conjunctival carcinoma; electronic brachytherapy; kilovoltage; low-energy X-rays; single-fraction brachytherapy.

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Conflict of interest statement

G.R.S.: Grants and personal fees from Carl Zeiss Meditec AG, outside of the submitted work. S.S.: Nothing to disclose. M.B.: Nothing to disclose. D.R.: Nothing to disclose. P.F.R.: Nothing to disclose. F.A.G.: reports other from Implacit GmbH, non-financial support from Oncare GmbH, grants and personal fees from NOXXON Pharma AG, grants and personal fees from Carl Zeiss Meditec AG, personal fees from Bristol-Myers Squibb, personal fees from Roche Pharma AG, personal fees from MSD Sharp and Dohme GmbH, and personal fees from AstraZeneca GmbH, outside the submitted work. In addition, F.A.G. has a patent (US 62/435405) pending. G.J.S.: has received grants and personal fees from Carl Zeiss Meditec AG, outside of the submitted work.

Figures

Figure 1
Figure 1
Estimated disease-free survival curves according to the Kaplan–Meier method.
Figure 2
Figure 2
Exemplary treatment simulation and dose distribution of a 1-cm applicator. (A) The beige, brown, and green curves represent the 100%, 50%, and 20% isodose lines, respectively; (B) dose–volume histogram and Dmax on OARs.
Figure 3
Figure 3
(A,B): Pre-surgery and post-e-BT status; (C,D): application procedure.
See this image and copyright information in PMC

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