Recommendations of the Spanish brachytherapy group (GEB) of Spanish Society of Radiation Oncology (SEOR) and the Spanish Society of Medical Physics (SEFM) for high-dose rate (HDR) non melanoma skin cancer brachytherapy
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Clinical indications of brachytherapy in non-melanoma skin cancers, description of applicators and dosimetry recommendations are described based on the literature review, clinical practice and experience of Spanish Group of Brachytherapy and Spanish Society of Medical Physics reported in the XIV Annual Consensus Meeting on Non Melanoma Skin Cancer Brachytherapy held in Benidorm, Alicante (Spain) on October 21st, 2016. All the recommendations for which consensus was achieved are highlighted in blue. Regular and small surfaces may be treated with Leipzig, Valencia, flap applicators or electronic brachytherapy (EBT). For irregular surfaces, customized molds or interstitial implants should be employed. The dose is prescribed at a maximum depth of 3–4 mm of the clinical target volume/planning target volume (CTV/PTV) in all cases except in flaps or molds in which 5 mm is appropriate. Interstitial brachytherapy should be used for CTV/PTV >5 mm. Different total doses and fraction sizes are used with very similar clinical and toxicity results. Hypofractionation is very useful twice or 3 times a week, being comfortable for patients and practical for Radiotherapy Departments. In interstitial brachytherapy 2 fractions twice a day are applied.
KeywordsSkin brachytherapy Technical Dosimetric aspects Consensus
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 10.Ballester-Sánchez R, Pons-Llanas O, Candela-Juan C, Celada-Alvárez FJ, de Unamuno-Bustos B, LLavador-Ros M, et al. Efficacy and safety of electronic brachytherapy for superficial and nodular basal cell carcinoma. J Contemp Brachytherapy. 2015;7(3):331–8.Google Scholar
- 11.NCCN Clinical Practice Guidelines in Oncology. Squamous Cell Skin Cancer Version 1.2017 NCCN.org.Google Scholar
- 12.NCCN Clinical Practice Guidelines in Oncology. Basal Cell Skin Cancer Version 1.2017 NCCN.org.Google Scholar
- 13.TNM staging American Joint Committee on Cancer. 7th ed. In: Sobin LH, Gospodarowicz MK, Wittekind Ch, editors. TNM Classification of Malignant Tumors, 7th ed. Oxford: Wiley-Blackwell, 2009. 310 p. ISBN 978-1-4443-3241-4.Google Scholar
- 17.Fulkerson RK, Micka JA, DeWerd LA. Dosimetric characterization and output verification for conical brachytherapy surface applicators. Part II. High dose rate 192Ir sources. Dosimetric characterization and output verification for conical brachytherapy surface applicators. Part II. Med Phys. 2014;41(2):022104.CrossRefPubMedPubMedCentralGoogle Scholar
- 26.Lam SCP, Xu Y, Ingram G, et al. Dosimetric characteristics of INTRABEAM® flat and surface applicators. Transl Cancer Res. 2014;3:106–11.Google Scholar
- 27.Schneider F, Clausen S, Thölking T, Wenz F, Abo-Madyan Y. A novel approach for superficial intraoperative radiotherapy (IORT) using a 50 kV X-ray source: a technical and case report. J Appl Clin Med Phys. 2014;5:4502.Google Scholar
- 30.Jankarashvili N, Topeshashvili M. Treatment of skin cancer with intrabeam. 9th ZEISS INTRABEAM User Meeting. 2015.Google Scholar
- 34.Rodriguez-Villalba S, Perez-calatayud MJ, Bautista JA, Carmona V, et al. Novel simple templates for reproducible positioning of skin applicators in brachytherapy. J Contemp Brachytherapy. 2016;8(4):1–5.Google Scholar