Abstract

*M. Hommadi, H. Bakkali, O. Houessou, M. Benlemlih, T. Elmorjani, N. Bendahou, I. LAHDIRI, S. Boutayeb, S. El Mejjaoui, H. EL Kacemi, T. Kebdani and N. Benjaafar

ABSTRACT

Purpose: Skin cancers are the most common human malignancy with increasing incidence. Currently, surgery is standard of care treatment for non-melanoma skin cancers. However, brachytherapy (BT) is a growing modality in the management of skin cancers. In this study, we aimed to assess the outcome of patients with non-melanoma skin cancers treated by high-dose-rate (HDR) brachytherapy with FLAP Freiburg applicator in our department. Materials and methods: In this retrospective study, we recruited patients with Non-melanoma skin cancer (NMSC) who underwent post-operative brachytherapy during 2016-2018. Skin brachytherapy using the FLAP Freiburg applicator was indicated in all our patients. They were treated with after- loading HDR brachytherapy machine, with a total dose of 20-40 Gy in 5-8 fractions. Patients were followed to evaluate radiation toxicity, and local failures. Results: A total of 8 patients (75% male; median age, 70 years) were included, all of them received adjuvant brachytherapy after surgery with close or positive margins for NMSC. Fifty percent of lesions were squamous cell carcinoma (SCC) and 37.5% were basal cell carcinoma (BCC). The mean total dose was 35.6 Gy. The average follow-up was 26,4 months (17 to 39 months), low acute dermal reactions were noted for all patients, one patient present grade 3 radiodermatitis, and one patient developed skin fibrosis. One case of locoregional relapse was noted and no patient developed distant metastases, all patients are alive, one patient was lost to follow-up after the end of brachytherapy. Conclusion: With appropriate patient selection and choosing as lowest dose per fraction as possible, HDR brachytherapy with FLAP Freiburg applicator yields good oncological and cosmetic results for the adjuvant treatment of localized NMSC.