Esmati Ebrahim, Abyaneh Romina, Jaberi Ramin, Naderinasab Sahar, Gholami Soraya, Payandeh Milad, Salarvand Fereshteh, Khalilian Alireza, Seiri Mahnaz, Lashkari Marzieh, Babaei Mohammad, Aghili Mahdi, Kazemian Ali, Kamrava Mitchell, Ghalehtaki Reza
Department of Radiation Oncology, Cancer Institute, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Radiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
J Contemp Brachytherapy. 2024 Oct;16(5):323-334. doi: 10.5114/jcb.2024.144703. Epub 2024 Oct 28.
Non-melanoma skin cancer (NMSC) is the most prevalent cancer worldwide, particularly affecting head and neck region. Surgical excision, especially Moh's microsurgery, is the gold standard for treatment. However, certain patients' factors, such as age, comorbidities, and tumor location, require alternative therapies. Radiotherapy, particularly surface mold brachytherapy, offers a viable option for these inoperable or high-risk surgical candidates.
This retrospective cohort study included 22 patients with histologically confirmed NMSC, treated with high-dose-rate (HDR) surface mold brachytherapy at the Cancer Institute of Iran between 2019 and 2021. The study focused on primary outcomes, including local control and overall survival, with follow-up assessments for acute and late toxicities, treatment response, and cosmetic outcomes.
Twenty-two patients (mean age, 70.94 years) with NMSC were treated. The median lesion size was 2.46 cm. The basal cell carcinoma (BCC) to squamous cell carcinoma (SCC) ratio was 14 : 8. The median maximum depth of clinical target volume was 10 (IQR: 9-15). The median dose was 39 Gy in 13 fractions, with a D of 3.04 Gy. Lesions were mainly located on the nose, scalp, and cheek. The 2-year local control rates were 92.9% for BCC and 87.5% for SCC. The 2-year overall survival rate was 71%, with 80% for BCC and 55% for SCC. Eight patients died during the follow-up period, of these, five were due to cancer. Recurrence occurred in one BCC patient (7.1%) and one SCC (12.5%) case. Acute toxicities were mild, and no severe late complications were observed, indicating good tolerance and favorable cosmetic outcomes.
Surface mold brachytherapy using cobalt-60 source is an effective and safe treatment for head and neck NMSC, even in thicker than 5 mm lesions, offering high local control rates and favorable cosmetic outcomes. This technique presents a valuable alternative for patients unsuitable for surgery, warranting further research with larger cohorts for confirmation and treatment protocol optimization.
非黑色素瘤皮肤癌（NMSC）是全球最常见的癌症，尤其好发于头颈部区域。手术切除，特别是莫氏显微外科手术，是治疗的金标准。然而，某些患者因素，如年龄、合并症和肿瘤位置，需要采用替代疗法。放射治疗，尤其是表面敷贴近距离放射治疗，为这些无法手术或手术风险高的患者提供了一种可行的选择。
这项回顾性队列研究纳入了2019年至2021年期间在伊朗癌症研究所接受高剂量率（HDR）表面敷贴近距离放射治疗的22例经组织学确诊的NMSC患者。该研究聚焦于主要结局，包括局部控制和总生存率，并对急性和晚期毒性、治疗反应及美容效果进行随访评估。
22例NMSC患者（平均年龄70.94岁）接受了治疗。病变的中位大小为2.46厘米。基底细胞癌（BCC）与鳞状细胞癌（SCC）的比例为14:8。临床靶体积的中位最大深度为10（四分位间距：9 - 15）。中位剂量为39 Gy，分13次给予，D为3.04 Gy。病变主要位于鼻子、头皮和脸颊。BCC的2年局部控制率为92.9%，SCC为87.
