Brachytherapy最新文献

{"title":"PO102","authors":"Genghao Zhao, Huajian Wu, Wenyue Duan, Jinyu Wu, Liang Yang, Zhe Wang, Ruoyu Wang","doi":"10.1016/j.brachy.2023.06.203","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.203","url":null,"abstract":"Purpose This study aimed to assess the clinical efficacy and safety of Stereotactic ablative brachytherapy (SABT) for unresectable or inoperable head and neck cancers. Material and Methods This study retrospectively assessed the clinical data of 40 patients with unresectable or inoperable head and neck cancers treated with SABT from October 2016 to October 2021. The variables assessed were local efficacy, progression-free-survival (PFS) rate, overall survival (OS) rate, and radiological adverse effects. Results The median follow-up was of 34 months (range, 5-59 months), and PFS rate at 6, 12, and 24 months was 90.0%, 74.7%, and 66.3%, respectively. The median survival time was of 16 months [95% confidence interval (CI), 10.2-21.8 months] and the OS rate at 6, 12, and 24 months was 97.5%, 70.0%, and 34.6%, respectively. The results of the univariate analysis revealed that the type of pathology and GTV D90 were related to PFS rate (P<0.05). However, the type of pathology, GTV D90, age, and implantation site were related to OS rate (P<0.05). The results of the multivariate analysis revealed that the GTV D90 was related to PFS rate (P<0.05). The type of pathology and GTV D90 were related to OS rate (P<0.05). The evaluation of postoperative radiological adverse reactions revealed that seven cases (17.5%) developed grade I/II skin reactions, four cases (10.0%) developed grade I/II oral mucosal reactions, and no cases developed grade III or higher adverse reactions. Postoperative seed dislocation occurred in three patients with tongue cancer. Conclusions SABT has produced good local control and mild adverse reactions in the treatment of unresectable or inoperable head and neck cancers. Additionally, it is safe, feasible, minimally invasive, and has fewer adverse effects than other treatment modalities. This study aimed to assess the clinical efficacy and safety of Stereotactic ablative brachytherapy (SABT) for unresectable or inoperable head and neck cancers. This study retrospectively assessed the clinical data of 40 patients with unresectable or inoperable head and neck cancers treated with SABT from October 2016 to October 2021. The variables assessed were local efficacy, progression-free-survival (PFS) rate, overall survival (OS) rate, and radiological adverse effects. The median follow-up was of 34 months (range, 5-59 months), and PFS rate at 6, 12, and 24 months was 90.0%, 74.7%, and 66.3%, respectively. The median survival time was of 16 months [95% confidence interval (CI), 10.2-21.8 months] and the OS rate at 6, 12, and 24 months was 97.5%, 70.0%, and 34.6%, respectively. The results of the univariate analysis revealed that the type of pathology and GTV D90 were related to PFS rate (P<0.05). However, the type of pathology, GTV D90, age, and implantation site were related to OS rate (P<0.05). The results of the multivariate analysis revealed that the GTV D90 was related to PFS rate (P<0.05). The type of pathology and GTV D90 were related to OS r","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO110","authors":"Juan Wang, Guohui Cao","doi":"10.1016/j.brachy.2023.06.211","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.211","url":null,"abstract":"Purpose To investigate the prognostic value of neutrophil-lymphocyte ratio in patients with advanced lung cancer treated with radioactive iodine 125 seeds implantation. Methods From January 2017 to March 2021, 49 patients with advanced lung cancer received iodine 125 seed implantation in our hospital. use χ The influencing factors of clinical efficacy were analyzed. The optimal preoperative NLR limit was obtained by establishing the receiver operating characteristic curve (ROC). The clinicopathological factors were analyzed by logistic univariate analysis and multivariate survival analysis by binary logistics. Results The total effective rate of 49 patients 6 months after treatment was 65.31% (32 / 49). Univariate analysis showed that the maximum tumor diameter (χ2 = 6.69, P = 0.0097), postoperative D90 (χ2= 9.55, P = 0.002), preoperative NLR(χ2= 9.32, P = 0.0023). Multivariate analysis showed that postoperative D90 (P = 0.048) and preoperative NLR (P = 0.018) were independent prognostic factors of local effective rate after lung cancer seed implantation. Conclusions Radioactive iodine 125 seed implantation showed good efficacy in the treatment of patients with advanced lung cancer. Preoperative NLR and postoperative D90 were independent prognostic factors for the effective rate after lung cancer seed implantation, High NLR is a poor prognostic factor for lung cancer seed implantation. To investigate the prognostic value of neutrophil-lymphocyte ratio in patients with advanced lung cancer treated with radioactive iodine 125 seeds implantation. From January 2017 to March 2021, 49 patients with advanced lung cancer received iodine 125 seed implantation in our hospital. use χ The influencing factors of clinical efficacy were analyzed. The optimal preoperative NLR limit was obtained by establishing the receiver operating characteristic curve (ROC). The clinicopathological factors were analyzed by logistic univariate analysis and multivariate survival analysis by binary logistics. The total effective rate of 49 patients 6 months after treatment was 65.31% (32 / 49). Univariate analysis showed that the maximum tumor diameter (χ2 = 6.69, P = 0.0097), postoperative D90 (χ2= 9.55, P = 0.002), preoperative NLR(χ2= 9.32, P = 0.0023). Multivariate analysis showed that postoperative D90 (P = 0.048) and preoperative NLR (P = 0.018) were independent prognostic factors of local effective rate after lung cancer seed implantation. Radioactive iodine 125 seed implantation showed good efficacy in the treatment of patients with advanced lung cancer. Preoperative NLR and postoperative D90 were independent prognostic factors for the effective rate after lung cancer seed implantation, High NLR is a poor prognostic factor for lung cancer seed implantation.","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO65","authors":"Eulanca Yuka Liu, Eric Lin, Puja Venkat, Alan Lee, Jay Shiao, Andrew Wong, Austin Yu, Mary Ann Hagio, Sang-June Park, D. Jeffrey Demanes, Albert J. Chang","doi":"10.1016/j.brachy.2023.06.166","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.166","url":null,"abstract":"Purpose This retrospective study compares high dose rate brachytherapy (HDR BT) monotherapy against HDR BT and external beam radiation therapy (EBRT), with and without androgen deprivation therapy (ADT), to determine non-inferiority of HDR BT alone in the treatment of unfavorable intermediate risk (UIR) prostate cancer. Materials/Methods Data were obtained from two registries from 1991-present. 633 patients with UIR prostate cancer treated with HDR BT were included. Patients who received only HDR BT received 42-45Gy/6 fractions (fx) or 27 Gy/2 fx. For HDR BT+EBRT, the HDR dose was 20-24 Gy/2 fx, 24 Gy/4 fx, or 15 Gy/1 fx. EBRT patients received 45 Gy/25 fx to the prostate +/- pelvic nodal radiation. GU/GI toxicities were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Treatment group differences were assessed via two-sample T test or ANOVA, and associations between categorical variable and treatment group were assessed via chi-squared or Fisher's exact test. Time-to-event analyses were carried out to evaluate relationship between treatments and primary outcome variables. Five primary endpoints were used to assess freedom from biochemical recurrence (FFBC), freedom from distant metastasis (FFDM), freedom from local failure (FFLF), cancer specific survival (CSS), and overall survival (OS). Univariate analysis was conducted using the Kaplan-Meier method and log-rank test to the primary event. For multivariate analysis, Cox proportional hazard (Cox PH) regression and Fine & Gray competing risk regression were carried out to adjust for potential confounders. For toxicity analysis, the association between the incidence of post-treatment severe GU/GI toxicity reaction, denoted grade 3 or higher, and the treatment group was evaluated via chi-squared or Fisher's exact test. Results Statistical comparisons for HDR, HDR+EBRT-ADT, and HDR+EBRT+ADT are summarized in Table 1. From the Kaplan-Meier curves and log-rank tests, no differences between the three cohorts were identified in all five survival outcomes (FFBC, FFDM, FFLF, OS, CSS), with 5-year survival for HDR, HDR+EBRT-ADT, and HDR+EBRT+ADT FFBC 99%, 95%, and 94% respectively. Multivariate analysis with Cox PH regression showed no differences in FFBC, FFDM, OS, and CSS with addition of EBT alone, or addition of EBT with ADT. Fine and Gray competing regression showed no difference in outcome for HDR, HDR+EBRT-ADT, and HDR+EBRT+ADT with respect to FFBC, FFDM, and CSS. Performing the likelihood ratio test to both the Cox PH and Fine & Gray competing regression models resulted in no differences in all survival outcomes with stable fits between treatment and non-treatment groups. In comparing CTCAE toxicities between the HDR, HDR+EBRT-ADT, and HDR+EBRT+ADT cohorts, no statistically significant differences were identified in GI and GU toxicities when comparing post-treatment and baseline toxicities. No Grade 2 or 3 GI toxicities were identified in any of the groups, while ","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO112","authors":"Juan Wang, Xiaolu Pei","doi":"10.1016/j.brachy.2023.06.213","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.213","url":null,"abstract":"Purpose A meta-analysis aimed to systematically evaluate the safety and efficiency of iodine-125 (125I) irradiation stent placement for patients with malignant biliary obstruction (MBO) Methods Embase, Medline, PubMed, Cochrane library, and OVID were systematically searched from the earliest to November 2021. The primary endpoints were stent patency and overall survival. The secondary endpoints were total bilirubin (TB) and alanine aminotransferase (ALT) level and complications. Two independent researchers strictly screened the documents, extracted the valuable data, and evaluated the quality of documents. Meta-analysis was performed using Stata 12.0 and RevMan 5.4 software. Results 950 patients were included in nine studies, 415 of them received 125I seed implantation and 535 were in the mental stents group. Meta analysis showed that the stent patency rate in the experimental group improved in 3 months (OR=5.19, 95%CI=2.74-9.8,P<0.01), and that in MBO patients also significantly increased in 6 months (OR=4.46, 95%CI=2.87-6.93, P<0.01). Meanwhile, the postoperative 6-month survival rate was significantly improved (OR=1.63, 95%CI=1.13-2.35, P=0.009).It also reduced patient's mortality risk (HR=0.67, 95%CI=0.5-0.86, P=0.002). Subgroup analysis found that different doses may lead to different patency rates. However, the postoperative 12-month survival rate was not improved. (OR=1.42, 95%CI=0.27-2.6, P=0.25). There was no significant difference in the occurrence of adverse events between the two groups (OR=1.24, 95%CI=0.69-2.21. P=0.47). Conclusions For patients with unresectable malignant biliary obstruction (MBO), placement of an irradiation stent has been demonstrated to offer longer patency and survival compared with the control group. Our aim was to further assess the efficacy of irradiation stents. A meta-analysis aimed to systematically evaluate the safety and efficiency of iodine-125 (125I) irradiation stent placement for patients with malignant biliary obstruction (MBO) Embase, Medline, PubMed, Cochrane library, and OVID were systematically searched from the earliest to November 2021. The primary endpoints were stent patency and overall survival. The secondary endpoints were total bilirubin (TB) and alanine aminotransferase (ALT) level and complications. Two independent researchers strictly screened the documents, extracted the valuable data, and evaluated the quality of documents. Meta-analysis was performed using Stata 12.0 and RevMan 5.4 software. 950 patients were included in nine studies, 415 of them received 125I seed implantation and 535 were in the mental stents group. Meta analysis showed that the stent patency rate in the experimental group improved in 3 months (OR=5.19, 95%CI=2.74-9.8,P<0.01), and that in MBO patients also significantly increased in 6 months (OR=4.46, 95%CI=2.87-6.93, P<0.01). Meanwhile, the postoperative 6-month survival rate was significantly improved (OR=1.63, 95%CI=1.13-2.35, P=0.009).It also reduced patient's","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"135 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO94","authors":"Derek Liu, Nawaid Usmani, Nick Chng, Ron Sloboda","doi":"10.1016/j.brachy.2023.06.195","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.195","url":null,"abstract":"Purpose Prostatic edema following transperineal interstitial permanent prostate brachytherapy implantation is commonly evaluated based on either prostate or implant volume. The current study compares the edema time course between the MR-delineated prostate contour and the CT-localized stranded seeds, enabling pairwise comparison in the presence of individual patient variation. In addition, unique identification of seeds enables the characterization of stranded implant dynamics. Materials and Methods Twenty patients were implanted with stranded Iodine-125 seeds (0.5 U strength) to the prostate at a prescribed dose of 145 Gy, following standard procedure. Pelvic scans were performed using computer tomography (CT) and magnetic resonance imaging (MRI) (T2-weighted fast spin-echo and balanced steady-state free precession (bSSFP)) on the day of implantation (D0), D3, D10, and D30 (30 days post-implant). A Prostate Coordinate System, based on the MR-delineated prostate contour, served as a common coordinate system across all time points. MR(bSSFP)-CT rigid registration was performed based on the mutual information metric. A strand reconstruction software uniquely matched individual seeds to the strand configuration in the preplan. The relative edema, normalized to D30, was calculated for MR-based contours and CT-based seed positions. Correlated movement of seeds within a strand were quantified: strand movement was calculated from the shift in the strand center-of-mass; strand length was determined as the total length of the line segments connecting sequential seeds in a strand. Simulation of the stranded seed model was performed. Initial D0 seed positions were moved based on the observed strand characteristic movement and compared against actual D30 seed positions. Results Prostatic edema resulted in swelling of the prostate, which peaks at D0 and mostly resolves by D30. The contour- and seed- based relative edema were similar and correlated (p < 0.01) in the lateral and ant-pos directions. The edema magnitudes differed noticeably in the sup-inf direction with no statistically significant correlation (p = 0.11). The average strand movement was 0.09, 0.12, and 0.26 cm in the Lateral, Ant-Pos, and Sup-Inf directions respective, resulting in a more compact seed distribution. The movement was largest between D0 and D3 and smallest between D10 and D30. Conversely, the strand length was relatively constant during the initial time points, followed by a length contraction of 5% between D10 and D30. Thus, the stranding material initially limits independent seed movement (i.e. strands moved as a whole) and subsequently loses integrity over time, allowing for strand contraction. Simulation of the stranded seed model reproduced the observed relative edema, particularly in the Sup-Inf strand direction. The average residual distance between simulated and actual D30 seed positions was 0.27 cm. For comparison, the actual seed movement was 0.38 cm and the residual from ","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO120","authors":"Sang June Park, Serhii Brovchuk, Zoia Shepil, Oleg Vaskevych, Puja Venkat","doi":"10.1016/j.brachy.2023.06.221","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.221","url":null,"abstract":"","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO87","authors":"Danilo Maziero, Catheryn Yashar, Jyoti Mayadev, Dominique Rash, Daniel Scanderbeg","doi":"10.1016/j.brachy.2023.06.188","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.188","url":null,"abstract":"Purpose To propose a generalization of the known relationship between total reference air Kerma (TRAK) and isodose surface volumes for intracavitary, hybrid and interstitial applicators used for treating cervical cancer with high dose rate (HDR) brachytherapy (BT). Materials and Methods A single institution cohort of 123 retrospective clinical HDR BT plans from 34 patients treated for cervical cancer were evaluated. The cohort consisted of 71 intracavitary (tandem and ring - T&R - and tandem and ovoid - T&O), 32 hybrid (T&R or T&O with the addition of stainless steel and/or flexi needles) and 20 interstitial plans. Patients received 45Gy external beam radiotherapy (EBRT), followed by one of three fractionation schemes delivered with BT: 600cGy x 4 fractions (4 patients for a total of 16 fractions), 700cGy x 4 fractions (21 patients for a total of 80 fractions) and 800cGy x 3 fractions (9 patients for a total of 27 fractions). The average dose per fraction was 708.9±58.5cGy considering all 123 plans. For each plan the isodose surface volumes (TPSvol) were evaluated considering the accumulated EBRT and BT dose. Because three different fractionation schemes were used, the radiobiological equivalent doses in 2Gy fractions (EQD2) were estimated considering the EBRT and BT contributions. We have considered α/β ratio = 10Gy for tumor repair and repair half time T1/2 = 1.5 hour. In this work we have considered three reference dose levels (dref): 60Gy, 75Gy and 85Gy. Figure 1A-C illustrates the isodose surface volumes for the different fractionation schemes. The TRAK of each plan was also recorded. The relationship between TRAK/dref and TPSvol for the different applicators was evaluated by applying a second degree polynomial linear regression considering the two variables for each case. Results The linear regressions showed correlation coefficients R2 of 0.998, 0.997, 0.995 and 0.997 for the data obtained from treatments using intracavitary (Fig. 1D), hybrid (Fig. 1E), interstitials (Fig. 1F) and all applicators together (Fig. 1G), respectively. The linear regressions were not found to be affected by the different fractionation schemes. The quadratic, linear coefficients and the curve intercepts ranged from 0.621 to 0.739, 11.29 to 12.64 and -16.9 to -12.32, respectively. The fitted equation for the hybrid implants (Fig. 1E) showed the largest differences for the quadratic coefficient and curve intercept when compared to the equation fitted for intracavitary and interstitial applicators. The equation resulting from all applicators (Fig. 1G) showed the smallest differences for quadratic and linear coefficients when compared to the equation resulting intracavitary applicators. Conclusions We have shown that TRAK might be useful to predict volumes of isodose surfaces independently of the applicator and fractionation scheme used for treating cervical cancer with BT. The potential to use the correlation between TRAK and volumes of isodose surfaces to predict p","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO48","authors":"Rustica Cerillo, Amber Malloy, Mary Ann Monson, Lisa Thigpen, Kimberly DeBaun","doi":"10.1016/j.brachy.2023.06.149","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.149","url":null,"abstract":"","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO46","authors":"Hayden Anthony Ansinelli, Arjit Baghwala, Chengfeng (Brandon) Li, Ramiro Pino, E. Brian Butler, Bin S. Teh, Andrew M. Farach","doi":"10.1016/j.brachy.2023.06.147","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.147","url":null,"abstract":"","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO116","authors":"Mustafa M. Basree, Charles Wallace, Jessica Schuster, Jessica Miller, Michael Lawless, Juliet L. Aylward, Yaohui Xu, Kristin Bradley, Randall J. Kimple, Adam Burr","doi":"10.1016/j.brachy.2023.06.217","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.217","url":null,"abstract":"Purpose Non-melanoma skin cancer is the most common cancer worldwide and its treatment in the elderly can pose significant challenges. We established a skin brachytherapy program primarily to treat older patients using the hypofractionated courses and superficial treatment depth afforded by this technique. Here we describe the first patients treated at our institution, including our initial oncologic results and toxicities. Materials and Methods This is a single-institution retrospective review of non-melanoma skin cancer patients treated at our institution from March 2020 to October 2022 with high dose rate brachytherapy with iridium-192. Either the 2 or 3 cm Valencia applicator was used to treat 25 of 27 lesions with a prescription depth of 3 mm. The Valencia was fixed in place using a clamp and patients were immobilized using a custom head sponge. The other two lesions were treated using a custom array of catheters in Aquaplast and a Freiburg flap. Baseline characteristics and treatment-related variables were summarized using descriptive statistics. Acute and late radiation toxicities were graded using RTOG Common Toxicity Criteria. Local control was evaluated using the Kaplan Meier method. Results Twenty-one patients were identified (n=11 F; n=10 M), with twenty-seven lesions. Median age 81 years (range, 55 to 104), with 85.2% basal- and 14.8% squamous-cell carcinoma. Median follow up was 10.1 months (1.0 to 31.8). Treated lesions were located on the face (n=14), head (n=6), lower extremity (n=5), and neck (n=2), with median lesion size of 8 millimeters (2.5 to 30). Patients were treated with median 40 Gy (40 to 48.5) in 8 fractions (5 to 16) prescribed to depth of 3 mm (3 to 5). RTOG grade 1 skin toxicity (mild erythema) was present in 17 lesions and grade 2 toxicity (brisk erythema) was present in 10 lesions. The most common late toxicity was hypopigmentation in 3 patients. One patient developed a late grade 3 ulcer in a poorly perfused lower limb. Local control was 95.7% on a per lesion basis at one year with a marginal failure in 1/27 lesions. Conclusions Our initial experience with non-melanoma skin brachytherapy has shown good local control with an acceptable safety profile in a predominantly elderly population. Treatment of non-melanoma skin cancers on the lower extremity in elderly patients remains an ongoing challenge due to the risk of late toxicity. Further studies are needed to compare the acute and late toxicity of surface brachytherapy to widely available external beam techniques such as electron beam radiation therapy. Currently, the excellent local control and short treatment courses provide a great treatment option for superficial, early stage non-melanoma skin cancers. Non-melanoma skin cancer is the most common cancer worldwide and its treatment in the elderly can pose significant challenges. We established a skin brachytherapy program primarily to treat older patients using the hypofractionated courses and superficial trea","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}