29 Skin Cancer

Skin Cancer

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THE GEC ESTROHANDBOOKOF BRACHYTHERAPY | Part II Clinical Practice Version 1 - 30/04/2017

14. KEY MESSAGES

• Carefully tailored brachytherapy is a good alternative, if not the treatment of choice for those lesions that cannot be safely re- moved by surgery. • Local control rates with interstitial LDR using doses of 60 - 65 Gy are excellent for T1 - T2 skin cancers. HDR has become the standard treatment, with the aim of delivering the equivalent dose.

• HDR and PDR can be used in interstitial implants with a B.I.D schedule, usually 3-4 Gy per fraction.

• In skin tumours with a depth of <5mm, contact brachytherapy through flaps, moulds or contact surface applicators without anaesthesia are effective. • In small size tumours, Leipzig, Valencia applicators or electronic devices yield excellent results with high doses per fraction twice a week. • In extensive flat lesions, customized flaps or moulds with taped plastic tubes at a distance from skin of at least 3-5mm to avoid overdose on the skin, can be used at 3-5Gy per fraction once daily or every other day. • No standard schedule can be recommended and total doses are based in experience. The dose on the skin surface should be recorded to correlate the outcome with late side effects.