HDR Brachitherapy for Basal Cell Carcinoma

Abstract

Aim: to evaluate tumor control, toxicity and cosmesis in patients with relapse of basal cell carcinoma (BSC) who underwent high-dose-rate brachytherapy (HDR-BT)using a regimen of hypofractionation. Case presentation: A 93-year-old male, Karnosky Performace Status 90%, was diagnosed to have a relapse of BSC. A biopsy confirmed a relapse of BSC. The patient underwent HDR-BT with 192 Ir. The prescription dose of 50 Gy in 20 fractions of 2.5 Gy was delivered daily. The Common Terminology Criteria for Adverse Events (CTCA v4.0) toxicity scale was used to asses acute toxicity and the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC) scale was used to asses late toxicity related to cosmesis. The treatment was well tolerated. Clinically, the lesion completely regressed. The skin acute toxicity was grade 2 CTCA v4.0 and late toxicity grade 1EORTC. When the patient was consulted about his cosmetic result, he was satisfied. At the median follow-up of 7 months, the patient was alive and disease-free. Conclusion: the HDR-BT can be an effective and safe treatment option for selected elderly patients with relapse skin cancer.