Surface brachytherapy in Skin Cancer with High Dose Rate Remote Afterloader: an Experience from Nepal Cancer Hospital and Research Center

Abstract

High Dose Rate (HDR) brachytherapy for skin cancer, such as basal cell carcinoma and squamous cell carcinoma, provides an alternative treatment option to surgery or, in recurrent cases. This is especially relevant for cancers on the nose, ears, eyelids, or lips. Surface mould brachytherapy is delivering ionizing radiations via a carrier device known as mould. At Nepal Cancer Hospital and Research Center (NCHRC) we have treated 5 patients with skin cancer by surface brachytherapy. We prepared different source carrier of mould (thermoplastic sheets, wax sheets, and both) that is designed to provide constant and reproducible geometry for source positioning. Total volume ranging from 4cc to 10 cc was treated with a total dose of 40.5Gy in 9 Fractions (twice a week) was prescribed at 0.5cm depth. 3 to 5 applicators were used at 0.5 to 1cm distance as required to cover the treatment area. The patient’s treatment was evaluated on routine treatment and follow-up after one-month post-treatment and every 3 months for a year. Skin reactions were found after 2 to 3 fractions of treatment. We followed up the patients after the 1^st and 6^th months of treatment. After treatment, we achieved a complete response without any major complications. Surface mould brachytherapy is a very effective treatment for treating carcinoma of skin where difficult curve surfaces are involved.