PowerPoint Presentation

Brachytherapy Advantages for Older/Frail Patients

• Brachytherapy is usually delivered as a hypofractionated treatment, which translates into fewer treatment visits for the patient • Short period of time in which the dose is delivered during each treatment session • Patients can be treated in a sitting position • Non-daily applications may increase patience compliance • Relatively homogenous dose distribution across the target area with rapid fall off - N.B. in aging skin often with suboptimal repair mechanisms • Interstitial brachytherapy is less dependent on patient (involuntarily) movement and reduces the risk of geographical miss • NMSC lesions on the lower limbs - poorly vascularised - brachytherapy may be considered the treatment of choice • In elderly patients (median age 84) treated with HDR and Valencia applicator 40Gy in 8 fractions achieved good local control and cosmesis (Delishaj et al, 2015) • SCRiBE analysis: better cosmetic results for BCCs/SCCs with BT compared to EBRT

Zaorsky, N. G., et al. (2018). "Skin CanceR Brachytherapy vs External beam radiation therapy (SCRiBE) meta- analysis." Radiother Oncol 126 (3): 386-393. Delishaj, D., et al. (2015). "Non-melanoma skin cancer treated with high-dose-rate brachytherapy and Valencia applicator in elderly patients: a retrospective case series." Journal of contemporary brachytherapy 7 (6): 437.