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

Ballester-Sánchez R, Pons-Llanas O, Candela-Juan C, Celada-Alvarez FJ, de Unamuno-Bustos B, Llavador-Ros M, Ballesta-Cuñat A, Barker CA, Tormo-Mico A, Botella-Estrada R, Perez-Calatayud J - J Contemp Brachytherapy (2015)

Bottom Line: Cosmesis was excellent, with more than 60% of cases without skin alteration and with subtle changes in the rest.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.

View Article: PubMed Central - PubMed

Affiliation: Dermatology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.

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.

No MeSH data available.


Related in: MedlinePlus

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
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4499517&req=5

Figure 0001: 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

Mentions: The gross tumor volume (GTV) was assessed clinically with the aid of a dermoscope [13]. A radial margin of 5 mm was added to establish the clinical target volume (CTV) and the minimum applicator that covered the whole CTV was selected (10, 15, 20, 25 or 30 mm). A specific applicator template named templates La Fe [9] was used in order to delineate a mark on the skin to fit the external diameter of the selected applicator (Fig. 1). Tumor depth was assessed by high frequency ultrasonography (HFUS) and histopathology. A minimum depth of 3 mm by convention was used for lesions having a depth of 3 mm or less, and for deeper lesions the specific lesion depth was used for prescription, with a maximum of 5 mm [14]. After attaching the selected applicator to the machine, it was centered on the lesion using the mark made, and positioned in full contact with the lesion. The Esteya® arm has several degrees of freedom in order to place the applicator (Fig. 2).


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

Ballester-Sánchez R, Pons-Llanas O, Candela-Juan C, Celada-Alvarez FJ, de Unamuno-Bustos B, Llavador-Ros M, Ballesta-Cuñat A, Barker CA, Tormo-Mico A, Botella-Estrada R, Perez-Calatayud J - J Contemp Brachytherapy (2015)

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
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499517&req=5

Figure 0001: 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
Mentions: The gross tumor volume (GTV) was assessed clinically with the aid of a dermoscope [13]. A radial margin of 5 mm was added to establish the clinical target volume (CTV) and the minimum applicator that covered the whole CTV was selected (10, 15, 20, 25 or 30 mm). A specific applicator template named templates La Fe [9] was used in order to delineate a mark on the skin to fit the external diameter of the selected applicator (Fig. 1). Tumor depth was assessed by high frequency ultrasonography (HFUS) and histopathology. A minimum depth of 3 mm by convention was used for lesions having a depth of 3 mm or less, and for deeper lesions the specific lesion depth was used for prescription, with a maximum of 5 mm [14]. After attaching the selected applicator to the machine, it was centered on the lesion using the mark made, and positioned in full contact with the lesion. The Esteya® arm has several degrees of freedom in order to place the applicator (Fig. 2).

Bottom Line: Cosmesis was excellent, with more than 60% of cases without skin alteration and with subtle changes in the rest.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.

View Article: PubMed Central - PubMed

Affiliation: Dermatology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.

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.

No MeSH data available.


Related in: MedlinePlus