Electronic brachytherapy for treatment of non-melanoma skin cancers: Clinical results and toxicities

Uma Goyal, Michael K. Cheung, Justin Suszko, Brady Laughlin, Yongbok Kim, Jeanette Askam, Hina Arif-Tiwari, Benjamin Slane, John Gordon, Baldassare Stea

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations


Purpose: Although surgical approaches are standard for most non-melanomatous skin cancers, some patients are not candidates due to medical co-morbidities or functional or cosmetic or lesion location. High-dose-rate electronic brachytherapy (HDR-EBT) may be an alternative treatment modality. Material and methods: A retrospective chart review was conducted from April 2011 to April 2013. All lesions were pathologically confirmed as malignant basal cell or squamous cell carcinoma. A HDR-EBT system delivered a median biological equivalent dose of 50 Gy total to a depth of 0.1-0.5 cm using various sizes of applicators. Treatment feasibility, acute and late toxicity, cosmetic outcomes, and local recurrence were assessed. Results: Thirty-three patients with a mean age of 76 years with 50 cutaneous lesions were treated. Locations included 17 extremity lesions and 33 head and neck lesions. After treatments, acute grade 3 moist desquamation developed in 9 of the lesions (18%). Acute grade 4 ulceration developed in 3 lesions in the lower extremity (6%) and 1 upper lip lesion (2%). These toxicities were improved after a median of 20 days. Amongst the 4 lesions with grade 4 toxicities, a greater proportion were in lower extremity lesions compared to head and neck lesions (75% vs. 25%). There was no difference in the rate of grade 3 and 4 toxicities between patients aged ≤ 75 years and aged > 75 years (p = 0.082). With a mean long-term follow-up of 45.6 months, there was 1 local recurrence treated with surgery and no reported late toxicities. Conclusions: Our experience with HDR-EBT for non-melanomatous skin cancers is encouraging in terms of efficacy and convenience for patients. Our long-term follow-up shows a good response in all treated sites. Caution should be used for extremity sites, and more fractionated regimens should be considered to avoid severe acute toxicities.

Original languageEnglish (US)
Pages (from-to)497-503
Number of pages7
JournalJournal of Contemporary Brachytherapy
Issue number5
StatePublished - 2021
Externally publishedYes


  • Clinical
  • Electronic brachytherapy
  • Toxicities

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging


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