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Case Reports
. 2024 Jun;42(2):154-159.
doi: 10.3857/roj.2023.00682. Epub 2024 Mar 4.

Implementing high-dose rate surface mould brachytherapy for carcinoma of eyelid: a practical approach and weekly review

Kanhu Charan Patro  1 , Ajitesh Avinash  2 , Arya Banidutta  3 , Chitta Ranjan Kundu  1 , Partha Sarathi Bhattacharya  1 , Venkata Krishna Reddy Pilaka  1 , Mrutyunjayarao Muvvala  1 , Ayyalasomayajula Anil Kumar  4 , Srinu Aketi  4 , Keerthiga Karthikeyan  1 , Bhargava Krishna Madasu  1 , Dona Treesa Vincent  1
Affiliations
Case Reports

Implementing high-dose rate surface mould brachytherapy for carcinoma of eyelid: a practical approach and weekly review

Kanhu Charan Patro et al. Radiat Oncol J. 2024 Jun.

Abstract

Surface mould brachytherapy is a conformal radiotherapy technique that can deliver high dose to the target while sparing nearby normal structures, Here, we aim to describe the procedurals details for high-dose rate (HDR) surface mould brachytherapy in sebaceous carcinoma of eyelid in a 54-year old lady. She was hesitant for surgery and any form of invasive intervention like interstitial brachytherapy. So, she was treated with surface mould HDR brachytherapy to a total dose of 52 Gy in 13 fractions at a dose of 4 Gy per fraction delivered twice daily using Iridium-192 isotope with no acute side effects. She was evaluated on a weekly basis for any radiation side effects and now she is disease-free for 6 months post-treatment with only mild dry eye. A detailed step-by-step procedure of surface mould technique, simulation procedure, dose prescription, planning, plan evaluation and treatment has been described in this paper. Surface mould HDR brachytherapy can be safely used as organ preserving modality of treatment for eyelid carcinoma.

Keywords: Brachytherapy; Eyelid carcinoma; High-dose rate; Sebaceous carcinoma; Surface mould.

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Conflict of interest statement

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
(A) The initial mass of size 0.8 cm × 0.5 cm in the lateral aspect of upper eyelid. (B) Placement of the wax coated mould underneath the eyelid to be treated. (C) Final immobilization mask with the catheters embedded in situ that are serially numbered.
Fig. 2.
Fig. 2.
Computed tomography (CT) scans after CT simulation depicting delineation of target and various organs-at-risk. (A) The delineation of clinical target volume (light blue), (B) anterior chamber (red), (C) lacrimal gland (pink), (D) lens (yellow), (E) eyeball (orange), and (F) wax-covered lead mould (deep blue).
Fig. 3.
Fig. 3.
(A) The 3-dimensional view of catheters with respect to target and organs-at-risk (OARs) along with source positions marked in red. (B) The isodose distribution in coronal view. (C) The dose volume histogram of the target and OARs. (D) The dose statistics table for the target and OARs.
Fig. 4.
Fig. 4.
(A–I) Depicts the review of the local site of brachytherapy from week 1 to week 9.
See this image and copyright information in PMC

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