3D technique in superficial brachytherapy: New attitude in old field of mycosis fungoides.

A case report of non-classical treatment choice for mycosis fungoides (MF) presented on the left upper eyelid and forehead. Superficial brachytherapy using 3D technique was prescribed to preserve the lens's functionality, and successfully eliminate malignant lesion. Treatment was conducted with high-dose-rate (HDR) brachytherapy using iridium-192 (Ir) source as a base and Flexitron device as an afterloader. Applicators were immobilized and located near the lesion by manually shaped molds. Doses were calculated using Oncentra treatment planning system (ELEKTA) with 3D models based on CT scans. A 12-month follow-up showed sustained remission without any late toxicity or recurrence of MF skin lesions on the face. The proposed approach utilizing superficial, mold-based HDR brachytherapy to navigate anatomical challenges is demonstrated to be a clinically effective treatment option for MF of the lower eyelid or other dose-limiting locations.