Oliveira Catarina N, Viveiros Cláudia, Travancinha Catarina, Mota António, Pino Inês, Fonseca João, Madaleno Tiago, Labareda Miguel, Santos Filomena, Esteves Susana
Radiotherapy, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, PRT.
Radiotherapy, Centro Hospilalar Barreiro Montijo, Barreiro, PRT.
Cureus. 2024 Jan 27;16(1):e53067. doi: 10.7759/cureus.53067. eCollection 2024 Jan.
Objective To report the outcomes with high-dose-rate (HDR) brachytherapy (BT) treatment in patients with lower eyelid basal cell carcinoma (BCC) and to evaluate the relationship between dosimetric parameters and acute and late toxicities. Material and methods A retrospective unicentric study with patients diagnosed with lower eyelid biopsy-proven BCC treated with HDR BT between January 2012 and December 2019. The prescribed dose was 36 Gy to 40 Gy in 9 to 10 fractions, twice daily, over five days. The primary endpoint was local control, and the secondary endpoints were acute and late toxicities, registered according to CTCAE v4.0. The cosmetic result was evaluated on a qualitative scale (the CAIB scale). Local control was calculated according to the Kaplan-Meier test. Two sample T-tests and a Wilcoxon signed-rank test were used to determine the association between dosimetric parameters and side effects. Results Fifty-eight patients with a median age of 76 years were included. Among these patients, 55.2% received adjuvant HDR BT and 44.8% received radical HDR BT. At a median follow-up of 44 months, there were four local relapses, achieving a probability of local control at four years of 95% and 100% in the adjuvant and radical groups, respectively. Acute toxicity occurred in 76% of patients with only one grade 3 event (radiation dermatitis). Late toxicity was present in 56%. Eight patients underwent treatment for grade 3 cataracts during follow-up. Cosmetic results were excellent or very good in 93% of patients. Acute conjunctival hyperemia is strongly associated with the dose received by the ocular globe (volumes of 0.1cc, 1cc, and 2 cc) (p<0.05). Conclusion Lower eyelid BCC treatment with interstitial HDR BT is associated with excellent local control, acceptable long-term side effects, and good cosmetic results.
目的 报告高剂量率（HDR）近距离放射治疗（BT）在下睑基底细胞癌（BCC）患者中的治疗结果，并评估剂量学参数与急性和晚期毒性之间的关系。材料与方法 一项回顾性单中心研究，研究对象为2012年1月至2019年12月期间经活检证实为下睑BCC并接受HDR BT治疗的患者。规定剂量为36 Gy至40 Gy，分9至10次，每天两次，共五天。主要终点是局部控制，次要终点是急性和晚期毒性，根据CTCAE v4.0进行记录。根据定性量表（CAIB量表）评估美容效果。根据Kaplan-Meier检验计算局部控制率。使用两样本T检验和Wilcoxon符号秩检验来确定剂量学参数与副作用之间的关联。结果 纳入58例患者，中位年龄76岁。其中，55.2%接受辅助性HDR BT，44.8%接受根治性HDR BT。中位随访44个月时，有4例局部复发，辅助组和根治组四年局部控制概率分别为95%和100%。76%的患者发生急性毒性，仅1例3级事件（放射性皮炎）。56%存在晚期毒性。随访期间有8例患者因3级白内障接受治疗。93%的患者美容效果为优或良。急性结膜充血与眼球接受的剂量（0.1cc、1cc和2 cc体积）密切相关（p<0.05）。结论 间质HDR BT治疗下睑BCC具有良好的局部控制、可接受的长期副作用和良好的美容效果。
