Brachytherapy Treats Skin Cancer in Elderly Patients

Excellent local control and cosmetic outcomes are observed in elderly patients receiving high dose-rate brachytherapy (HDRBT) for early-stage nonmelanoma skin cancer of the head and neck region, according to a study presented at the annual meeting of the Radiological Society of North America.

Ashwatha Narayana, M.D., from Northern Westchester Hospital in Mount Kisco, New York, and colleagues evaluated a series of 70 patients with 81 lesions of either basal cell carcinoma (BCC: 53 lesions) or squamous cell carcinoma (SCC: 28 lesions) treated between August 2013 and August 2019. Patients (median age, 85 years) were treated with HDRBT and received a fractionation regimen of 700 cGy per fraction for six sessions over two weeks.

Patients were followed for a median of 24 months. The researchers found that local control was 98 and 96 percent for BCC and SCC, respectively. One patient with SCC and one with BCC recurred at three and six months, respectively, from time of therapy. Both recurrences involved a lower extremity and were >2 cm in size. In 90 percent of cases, the cosmetic outlook was excellent. In six patients, minor late effects included hypopigmentation, hyperpigmentation, telangiectasia, and atrophy of the skin. Twelve and 14 months after completion of therapy, two patients experienced wound breakdown. There were no cases of cartilage necrosis reported.

"High-dose-rate brachytherapy is a powerful way of treating skin cancers in both elderly and younger patients," Narayana said in a statement. "The results are impressive."

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