Pons-Llanas Olga, Ballester-Sánchez Rosa, Celada-Álvarez Francisco Javier, Candela-Juan Cristian, García-Martínez Teresa, Llavador-Ros Margarita, Botella-Estrada Rafael, Barker Christopher A, Ballesta Antonio, Tormo-Micó Alejandro, Rodríguez Silvia, Perez-Calatayud Jose
Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia, Spain.
Dermatology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.
J Contemp Brachytherapy. 2015 Jan;6(4):417-23. doi: 10.5114/jcb.2014.47996. Epub 2014 Dec 31.
Although surgery is usually the first-line treatment for nonmelanoma skin cancers, radiotherapy (RT) may be indicated in selected cases. Radiation therapy as primary therapy can result in excellent control rates, cosmetics, and quality of life. Brachytherapy is a radiation treatment modality that offers the most conformal option to patients. A new modality for skin brachytherapy is electronic brachytherapy. This involves the placement of a high dose rate X-ray source directly in a skin applicator close to the skin surface, and therefore combines the benefits of brachytherapy with those of low energy X-ray radiotherapy. The Esteya electronic brachytherapy system is specifically designed for skin surface brachytherapy procedures. The purpose of this manuscript is to describe the clinical implementation of the new Esteya electronic brachytherapy system, which may provide guidance for users of this system. The information covered includes patient selection, treatment planning (depth evaluation and margin determination), patient marking, and setup. The justification for the hypofractionated regimen is described and compared with others protocols in the literature. Quality assurance (QA) aspects including daily testing are also included. We emphasize that these are guidelines, and clinical judgment and experience must always prevail in the care of patients, as with any medical treatment. We conclude that clinical implementation of the Esteya brachytherapy system is simple for patients and providers, and should allow for precise and safe treatment of nonmelanoma skin cancers.
虽然手术通常是非黑色素瘤皮肤癌的一线治疗方法，但在某些特定情况下可能需要放疗（RT）。放射治疗作为主要治疗手段可实现极佳的控制率、美容效果和生活质量。近距离放射治疗是一种为患者提供最适形选择的放射治疗方式。皮肤近距离放射治疗的一种新模式是电子近距离放射治疗。这涉及将高剂量率X射线源直接放置在靠近皮肤表面的皮肤施源器中，因此将近距离放射治疗的优点与低能X射线放射治疗的优点结合起来。Esteya电子近距离放射治疗系统是专门为皮肤表面近距离放射治疗程序设计的。本手稿的目的是描述新型Esteya电子近距离放射治疗系统的临床应用，这可能为该系统的使用者提供指导。涵盖的信息包括患者选择、治疗计划（深度评估和边界确定）、患者标记和摆位。阐述了大分割方案的依据，并与文献中的其他方案进行了比较。还包括质量保证（QA）方面，包括每日检测。我们强调，这些是指导原则，与任何医疗治疗一样，在患者护理中临床判断和经验必须始终占主导地位。我们得出结论，Esteya近距离放射治疗系统的临床应用对患者和医护人员来说很简单，并且应该能够对非黑色素瘤皮肤癌进行精确且安全的治疗。
