PO111

Abstract

There is no one-size-fits-all treatment decision for non-melanoma skin cancer (NMSC) in elderly patients, especially patients over 80 years old with multiple comorbidities. As a minimally invasive technology, iodine-125 seeds interstitial brachytherapy (BT) has been applied to solid tumors of the whole body, because it can offer a better dose distribution, which considered to be an effective, simple and safe alternative for local treatment of cancer. We aimed to explore its safety and efficacy for age 80 or older patient with early primary high-risk NMSC. As a retrospective and monocentric report, we collected 80+ year-old patients with early primary high-risk non-melanoma skin cancer treated by personalized iodine-125 seeds interstitial brachytherapy (PISI-BT) between December 2003 and May 2020. Survival status, efficacy, adverse effects (AEs), cosmetic result, cost were recorded (data cut-off, November 20st 2021). Results Only 9 patients met the criteria, median age was 86 (81-90), 5 of 9 were Eastern Cooperative Oncology Group (ECOG) 1, and each of them suffered from at least one comorbidity. After a median follow-up of 29.3 months (3-99), only 2 patients alive, 6 patients showed complete response (CR), 3 showed partial response(PR), and stable disease(SD), progressive disease(PD) were 0, respectively. No recurrences, disease persistence and AEs were detected during the follow-up and the death causes was irrelevant to NMSC. The cosmetic result of Excellent and Good were 2 and 4, 3 cannot be evaluated. The cost (included in the scope of medical insurance reimbursement) was acceptable. Conclusions PISI-BT could be an alternative in 80+ year-old patients with early primary high-risk NMSC. There is no one-size-fits-all treatment decision for non-melanoma skin cancer (NMSC) in elderly patients, especially patients over 80 years old with multiple comorbidities. As a minimally invasive technology, iodine-125 seeds interstitial brachytherapy (BT) has been applied to solid tumors of the whole body, because it can offer a better dose distribution, which considered to be an effective, simple and safe alternative for local treatment of cancer. We aimed to explore its safety and efficacy for age 80 or older patient with early primary high-risk NMSC. As a retrospective and monocentric report, we collected 80+ year-old patients with early primary high-risk non-melanoma skin cancer treated by personalized iodine-125 seeds interstitial brachytherapy (PISI-BT) between December 2003 and May 2020. Survival status, efficacy, adverse effects (AEs), cosmetic result, cost were recorded (data cut-off, November 20st 2021). Only 9 patients met the criteria, median age was 86 (81-90), 5 of 9 were Eastern Cooperative Oncology Group (ECOG) 1, and each of them suffered from at least one comorbidity. After a median follow-up of 29.3 months (3-99), only 2 patients alive, 6 patients showed complete response (CR), 3 showed partial response(PR), and stable disease(SD), progressive disease(PD) were 0, respectively. No recurrences, disease persistence and AEs were detected during the follow-up and the death causes was irrelevant to NMSC. The cosmetic result of Excellent and Good were 2 and 4, 3 cannot be evaluated. The cost (included in the scope of medical insurance reimbursement) was acceptable. PISI-BT could be an alternative in 80+ year-old patients with early primary high-risk NMSC.