Anna O Likhacheva1, Phillip M Devlin2, Shervin M Shirvani3, Christopher A Barker4, Phillip Beron5, Ajay Bhatnagar6, Stephen W Doggett7, Lawrence Hochman8, Charles Hsu9, Michael Kasper10, Martin Keisch11, Subhakar Mutyala12, Bradley Prestidge13, Silvia Rodriguez Villalba14, Vershalee Shukla6, Srinath Sundararaman15, Mitchell Kamrava5. 1. Department of Radiation Oncology, Banner MD Anderson Cancer Center, Gilbert, AZ. Electronic address: anna.likh@gmail.com. 2. Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA. 3. Department of Radiation Oncology, Banner MD Anderson Cancer Center, Gilbert, AZ. 4. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY. 5. Department of Radiation Oncology, Ronald Reagan UCLA Medical Center UCLA Medical Center, Los Angeles, CA. 6. Department of Radiation Oncology, 21st Century Oncology, Phoenix, AZ. 7. Department of Radiation Oncology, Aegis Oncology, Tustin, CA. 8. Department of Radiation Oncology, Florida Cancer Affiliates, Trinity, FL. 9. Department of Radiation Oncology, University of Arizona Cancer Center, Tucson, AZ. 10. Department of Radiation Oncology, Boca Raton Regional Hospital, Boca Raton, FL. 11. Department of Radiation Oncology, Cancer Healthcare Associated, Miami, FL. 12. Department of Radiation Oncology, The University of Arizona Cancer Center at Dignity Health St. Joseph's Hospital, Phoenix, AZ. 13. Department of Radiation Oncology, Bon Secours Health System, Norfolk, VA. 14. Radiotherapy Department, Hospital Clínica Benidorm, Benidorm, Alicante, Spain. 15. Department of Radiation Oncology, Memorial Regional Hospital, Hollywood, FL.
Abstract
PURPOSE: The aim of this study was to define current patterns of care among radiation oncologists who use skin surface brachytherapy for the treatment of cutaneous squamous cell carcinoma (cSCC) and basal cell carcinoma (BCC) in academic and community settings. METHODS AND MATERIALS: A 30-question electronic survey was administered to clinician members of the American Brachytherapy Society. The respondents were asked to provide details regarding their clinical practice and their approach to skin surface brachytherapy. RESULTS: A total of 16 surveys were returned. Among the respondents, aggregate experience varied from 8 to 1800 cases. Most preferred brachytherapy over external beam radiation because of shorter treatment course, conformality of treatment for irregular or curved targets, and shallow dose deposition. Of the total, 60% of respondents routinely estimated lesion depth via ultrasound before initiating treatment. Treatment margin on gross disease varied widely (range, 3-15 mm; median, 5 mm). Hypofractionation was the preferred dose schedule. Prescribed doses ranged from 30 Gy in five fractions to 64 Gy in 32 fractions (EQD2, 40 Gy-65 Gy). There was a tendency to increase the number of fractions for larger targets, although some used the same fractionation regardless of anatomic location or lesion size. There was no consensus on dosimetric constraints, and some respondents reported cases of severe toxicity, particularly when treating the pretibial skin. CONCLUSIONS: This pattern of care study suggests that skin brachytherapy can be a convenient and safe tool for treatment of BCC and cSCC. Prospective trials and the development of expert consensus guidelines would be beneficial for optimizing skin surface brachytherapy and reducing practice variation.
PURPOSE: The aim of this study was to define current patterns of care among radiation oncologists who use skin surface brachytherapy for the treatment of cutaneous squamous cell carcinoma (cSCC) and basal cell carcinoma (BCC) in academic and community settings. METHODS AND MATERIALS: A 30-question electronic survey was administered to clinician members of the American Brachytherapy Society. The respondents were asked to provide details regarding their clinical practice and their approach to skin surface brachytherapy. RESULTS: A total of 16 surveys were returned. Among the respondents, aggregate experience varied from 8 to 1800 cases. Most preferred brachytherapy over external beam radiation because of shorter treatment course, conformality of treatment for irregular or curved targets, and shallow dose deposition. Of the total, 60% of respondents routinely estimated lesion depth via ultrasound before initiating treatment. Treatment margin on gross disease varied widely (range, 3-15 mm; median, 5 mm). Hypofractionation was the preferred dose schedule. Prescribed doses ranged from 30 Gy in five fractions to 64 Gy in 32 fractions (EQD2, 40 Gy-65 Gy). There was a tendency to increase the number of fractions for larger targets, although some used the same fractionation regardless of anatomic location or lesion size. There was no consensus on dosimetric constraints, and some respondents reported cases of severe toxicity, particularly when treating the pretibial skin. CONCLUSIONS: This pattern of care study suggests that skin brachytherapy can be a convenient and safe tool for treatment of BCC and cSCC. Prospective trials and the development of expert consensus guidelines would be beneficial for optimizing skin surface brachytherapy and reducing practice variation.
Authors: Anthony J Paravati; Peter G Hawkins; Amanda N Martin; Gina Mansy; Doug A Rahn; Sunil J Advani; Jeremy Hoisak; Irena Dragojevic; Peter J Martin; Charles J Miller; Parag Sanghvi Journal: Pract Radiat Oncol Date: 2015-07-17
Authors: Alejandro Tormo; Francisco Celada; Silvia Rodriguez; Rafael Botella; Antonio Ballesta; Michael Kasper; Zoubir Ouhib; Manuel Santos; Jose Perez-Calatayud Journal: J Contemp Brachytherapy Date: 2014-06-03
Authors: Łukasz Raszewski; Artur J Chyrek; Magdalena Marciniak; Wojciech M Burchardt; Grzegorz M Biele da; Adam Chicheł Journal: J Contemp Brachytherapy Date: 2021-05-07