(P127) One-Year Experience of Electronic Brachytherapy for the Treatment of Nonmelanoma Skin Cancer

Publication
Article
OncologyOncology Vol 28 No 1S
Volume 28
Issue 1S

There are over 3.0 million cases of nonmelanoma skin cancer (NMSC) diagnosed each year in the United States. Multiple treatment options exist for the treatment of these patients. We describe the outcomes of patients treated at a large private dermatology practice with electronic brachytherapy (eBx) who had a minimum follow-up duration of 1 year.

Robert Sinha, MD, Steven Kurtzman, MD, Neil McIlmoil, RTT, Greg Morganroth, MD; California Skin Institute; Western Radiation Oncology

Background: There are over 3.0 million cases of nonmelanoma skin cancer (NMSC) diagnosed each year in the United States. Multiple treatment options exist for the treatment of these patients, including excisional surgery, curettage, Mohs micrographic surgery, cryotherapy, topical chemotherapy, and radiotherapy. We describe the outcomes of patients treated at a large private dermatology practice with electronic brachytherapy (eBx) who had a minimum follow-up duration of 1 year.

Methods: A retrospective review of patients with NMSC treated with eBx in a large dermatology practice between January 2012 and September 2012 was performed. All patients had a biopsy to confirm the diagnosis of NMSC prior to treatment. Patients received between 40 Gy and 45 Gy in 3-Gy to 4-Gy fractions, delivered three times per week. The treatment was delivered with a Xoft Axxent controller (50-kV source). Photographs were taken to document treatment outcomes at all follow-up visits.

Results: A total of 58 patients with 74 lesions were identified. The median age was 76 years. There were 53 (72%) facial lesions, 18 (24%) lower extremity lesions, 2 (2.7%) upper extremity lesions, and 1 (1.3%) truncal lesion. There were 40 T1 lesions, 32 T2 lesions, and 2 Tis lesions. Follow-up ranged from 12 to 19 months with a median follow-up of 16 months. Local control was 98.6% in this patient population. Delayed wound healing (> 3 months post-treatment) occurred in four (5.4%) lesions, all lower-extremity tumors. Cosmesis was rated as good to excellent at all treated sites except for two (2.7%) who developed hypopigmentation. These two patients were treated to a dose of 40 Gy in 10 fractions.

Conclusions: Early experience at a large dermatology practice treating NMSC in the office setting with eBx shows excellent local control and acceptable cosmetic outcomes. Patients with lower-extremity lesions are at higher risk of developing delayed wound healing. Careful patient selection and dose selection should be considered in these patients. eBx is an effective treatment in NMSC and offers patients an effective nonsurgical option.

Articles in this issue

(P113) Age and Marital Status Are Associated With Choice of Mastectomy in Patients Eligible for Breast Conservation Therapy
(P112) Single-Institution Experience With Intrabeam IORT for Treatment of Early-Stage Breast Cancer
(P110) Breast Cancer Before Age 40: Current Patterns in Clinical Presentation and Local Management
(P111) Accelerated Partial-Breast Irradiation With Multicatheter High-Dose-Rate Brachytherapy: Feasibility and Results in a Private Practice Cohort
(P115) Breast Cancer Laterality Does Not Influence Overall Survival in a Large Modern Cohort: Implications for Radiation-Related Cardiac Mortality
(P117) Anatomical Variations and Radiation Technique for Breast Cancer
(P116) Bilateral Immediate DIEP Reconstruction and Postmastectomy Radiotherapy: Experience at a Tertiary Care Institution
(P118) Metadherin Overexpression Is Associated With Improved Locoregional Control After Mastectomy
(P119) Effect of Economic Environment on Use of Postlumpectomy Radiation Therapy for Stage I Breast Cancer
(P120) Immediate Versus Delayed Reconstruction After Mastectomy in the United States Medicare Breast Cancer Patient
(P121) Trend in Age and Racial Disparities in the Receipt of Postlumpectomy Radiation Therapy for Stage I Breast Cancer: 2004–2009
(P122) Streamlining Referring Physicians Orders With ‘Reflex Testing’ Significantly Decreases Time to Resolution for Abnormal Screening Mammograms
(P123) National Trends in the Local Management of Early-Stage Paget Disease of the Breast
(P124) Effect of Inhomogeneity on Cardiac and Lung Dose in Partial-Breast Irradiation Using HDR Brachytherapy
(P125) Breast Cancer Outcomes With Anthracycline-Based Chemotherapy for Residual Disease Burden After Full-Dose Neoadjuvant Chemotherapy and Surgery Followed by Radiation Treatment
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