Treatment of facial cutaneous carcinoma with high-dose rate contact brachytherapy with customized molds

摘要

Background: The main treatment given for initial stage facial epitheliomas is surgery, although there are alternatives. We present our results with Ir-192 high-dose rate (HDR) contact brachytherapy. Methods and Materials: Fifty-one epitheliomas, with a mean size of 1.5. cm and a maximum thickness of 3. mm, were treated with HDR contact brachytherapy by means of customized molds, with plastic tubes on bolus for flat surfaces and on wax molds for the nose. A total dose of 48-57. Gy, 3-4. Gy/fraction three times a week, was administered. Results: After a median followup of 45 months, five tumors relapsed (9.8%), four of them on the tip of the nose. The 5-year actuarial local control rate was 89%, 100% for flat surfaces, and 83% for the nose. All of them were salvaged with surgery. The treatment was well tolerated, 21.6% developed severe acute toxicity, with good or very good late cosmetic results. Conclusion: HDR contact brachytherapy is a good alternative to treat facial epitheliomas with a maximum thickness of 3. mm. Tip of the nose tumors are not well covered with this technique and a different procedure is required.