Unsealed188 Rhenium Resin Brachytherapy in Non-Surgical Candidates With Refractory Basal Cell Carcinoma: Clinical Outcomes.

IF 2.3 4区 医学 Q2 DERMATOLOGY
Marco Adriano Chessa, Carlotta Baraldi, Francesco Savoia, Lorenzo Maltoni, Giacomo Clarizio, Federica Filippi, BiancaMaria Piraccini, Emi Dika, Annalisa Pitino, Giovanni Tripepi, Federico Zagni, Lidia Strigari, Luigia Vetrone, Stefano Fanti, Paolo Castellucci
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Abstract

Introduction: High-dose brachytherapy using a non-sealed 188Rhenium resin (188Re) is a new treatment option for difficult-to-treat basal cell carcinoma (BCC) that ensures a radical oncological outcome minimizing side effects.

Objectives: The aim of this retrospective study was to evaluate the clinical efficacy of high-dose standardized brachytherapy using an unsealed 188Re in the management of difficult-to-treat BCCs and to evaluate the risk factors of relapses.

Methods: Between October 2017 and December 2022, patients affected by difficult-to-treat BCC were selected.

Inclusion criteria: histologically proven cutaneous BCC; thickness invasion no deeper than 3 mm; lesion located in the scalp, face, ears, or fingers or other areas in which surgery would have been difficult to perform or to destroy with scarce cosmetic-functional result; contraindication or refusal of surgery. All patients performed follow-up visits with videodermoscopy every 4-6 months.

Results: Sixty-four consecutive patients affected by 82 histologically proven high-risk BCCs, were enrolled: 60 were nodular, 9 sclerodermiform, and 13 superficial. Average follow-up was 24 months. Brachytherapy with 188Re resin achieved a complete response in 93% of "difficult-to-treat" BCCs, with relapses occurring on average 24 months after the initial treatment. No statistically significant difference in response to brachytherapy was found in the anatomical area treated, size of the tumor, or previously treated vs. naive BCCs. The sclerodermiform histotype had a 7-fold higher risk of recurrence than nodular histotype; recurrence occurred approximately 12 weeks earlier.

Conclusion: High-dose 188Re brachytherapy is a noninvasive, easy to perform, well-tolerated approach to treat difficult BCC when surgery or other therapy techniques are not feasible.

铼树脂近距离放疗在顽固性基底细胞癌非手术患者中的临床效果。
使用非密封188铼树脂(188Re)的大剂量近距离治疗是治疗难以治疗的基底细胞癌(BCC)的一种新选择,可确保根治性肿瘤结果,最大限度地减少副作用。目的:本回顾性研究的目的是评估使用非密封188Re进行高剂量标准化近距离放射治疗治疗难治性BCCs的临床疗效,并评估复发的危险因素。方法:选取2017年10月至2022年12月期间患有难以治疗的BCC的患者。纳入标准:组织学证实的皮肤基底细胞癌;厚度侵入不大于3mm;位于头皮、面部、耳朵、手指或其他手术难以实施或破坏且缺乏美容功能效果的部位的病变;手术禁忌症或拒绝。所有患者每4-6个月进行一次视频皮肤镜随访。结果:共纳入64例经组织学证实的高危bcc患者,其中结节性60例,硬皮状9例,浅表性13例。平均随访时间为24个月。188Re树脂近距离治疗在93%的“难治性”bcc中获得了完全缓解,在初始治疗后平均24个月复发。在治疗的解剖区域、肿瘤大小或先前治疗与初发bcc相比,对近距离放疗的反应没有统计学上的显著差异。硬皮组织型的复发风险比结节组织型高7倍;复发大约发生在12周前。结论:大剂量188Re近距离放疗是一种无创、易操作、耐受性良好的治疗方法,可用于手术或其他治疗技术不可行的困难基底细胞癌。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
1.40
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217
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