ESTRO 2023 - Abstract Book

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Digital Posters

ESTRO 2023

[2] RAMASESHAN, R. et al. Performance characteristics of a microMOSFET as an in vivo dosimeter in radiation therapy. Phys. Med. Biol., 2004, 49, 4031-4048 p.

Poster (Digital): Brachytherapy: Head and neck, skin, eye

PO-2184 Brachytherapy In The Elderly For Non-Melanoma Skin Carcers:A Single Center Experience

B. SANTO 1 , M.C. Barba 2 , E. Cavalera 3 , E. Ciurlia 2 , P. De Franco 2 , G. Di Paola 2 , S. De Matteis 2 , C. Federico 4 , A. Leone 2 , A. Papapleo 2 , D. Russo 2 1 Vito Fazzi Hospital , Radiation Oncology Department, LECCE, Italy; 2 Vito Fazzi Hospital, Radiation Oncology Department, LECCE, Italy; 3 Vito Fazzi Hospital, Radiation Oncology Department, LECCE, Italy; 4 University of Naples “Federico II", Advanced Biomedical Sciences, Naples, Italy Purpose or Objective Non-melanoma skin cancers (NMSCs) are the most common malignancy worldwide, of which 99% are basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) of skin. Mainstays of treatment remain surgery and radiotherapy, particularly in older patients ( ≥ 70 years old). High dose rate brachytherapy (HDR-BT), seems to be an excellent option for NMSC. Materials and Methods Between November 2011 and September 2022, we treated 16 patients for a total of forty-two lesions in aged patients with NMSC with HDR-BT. Patients underwent brachytherapy treatment for a total dose ranging from 30 to 40 Gy (10 Gy per fraction). Toxicities were recorded using the Common Terminology Criteria for Adverse Events scale (CTCAE) v. 4.03. Results Median age was 83 years. Acute toxicity was recorded in all patients. Grade 1 erythema appeared in 12 cases (28.6%) and it was self-resolved with the application of eudermic cream in 10 days; Grade 2 erythema appeared in all 28 cases(66.7%). Towards the end of each treatment schedule, epidermolysis developed which was resolved within 3 weeks; Grade 3 skin toxicity apperars in 2 cases (4.8%) and was managed with dressings and close outpatient follow-up until complete resolution in 5 weeks. Late toxicity: Grade 1 skin atrophy and pigmentation changes in field were observed in all patients. At last follow-up, all patients were disease free. Conclusion Personalized HDR-BT appears to be safe for older patients and management of skin toxicity is manageable. Furthermore, the treatment of the lesions avoids the complications associated with the progression of the disease. Purpose or Objective In recurrent head and neck (H&N) cancer after previous radical radiotherapy, surgical resection is sometimes not feasible. However, the efficacy of palliative external beam radiotherapy (EBRT) was limited because of the dose limitation. The purpose of this report was to present our experience of high-dose-rate brachytherapy (HDR-BT) in cases of inoperable recurrent H&N cancer after radical EBRT. Materials and Methods Between September 2020 and September 2021, five patients who had locoregional H&N cancer recurrence in the area of previous radical EBRT were treated with HDR-BT alone for definitive treatment. As per the previous radiotherapy, three and one patient received EBRT with 70 Gy in 35 fractions and 66 Gy in 33 fractions, respectively. Another patient received EBRT with 30 Gy in 5 fractions to the recurrence, after proton radiotherapy with 60 GyE in 30 fractions. The treatment sites of salvage interstitial brachytherapy were the neck lymph node region in four patients and the primary region of the nasal cavity in one patient. The dose and fractionation schedules used were 40-48 Gy in 6-9 fractions twice daily. Results The median age was 74 years old (range: 66-75 years). One patient was melanoma of nasal cavity, another was sebaceous carcinoma of the lower eyelid, and the other three were squamous cell carcinoma (SCC) of the oropharynx, hypopharynx, and lower eyelid. Three of five patients had pain or bleeding from their recurrent lesions. Because no distant metastases were detected, they received brachytherapy with a curative intent. The median follow-up period was 15.3 months (range: 0.3-19.8 months). The median overall survival was not achieved, and the median locoregional control period was 9.5 months (range: 3-20 months). Two patients (melanoma and SCC) died of the locoregional recurrence progression within 3 months, although one of them had symptomatic relief. The other three patients are alive. Two of three patients (SCC) are free from their disease. One patient (sebaceous carcinoma) had a recurrence in the same region, but re-HDR-BT controlled it. A severe cutaneous ulcer (grade3) was observed five months after re-HDR-BT. No grade ≥ 3 toxicity was found in the other four patients. Conclusion In patients with inoperable recurrent H&N cancer, HDR-BT can play a role in providing tumor control in addition to symptomatic relief in selected cases. PO-2185 High-dose-rate brachytherapy in recurrent head and neck cancer after the previous radiotherapy M. Sakuramachi 1 , N. Murakami 1 , T. Kashihara 1 , H. Igaki 1 1 National Cancer Center Hospital, Radiation Oncology, Tokyo, Japan