S101
Brachytherapy - Head & neck, skin, eye
ESTRO 2026
Pozna ń , Poland. 4 Medical Physics, Greater Poland Cancer Center, Pozna ń , Poland
Purpose/Objective: Basal cell carcinoma (BCC) of the head and neck (HaN) often arises in areas where surgery may cause functional or aesthetic compromise. The European Association of Dermato-Oncology (EADO) classifies stage IIa–IIIb lesions as difficult-to-treat (DTT), requiring organ-preserving approaches [1]. Interstitial or hybrid (contact + interstitial) interventional radiotherapy (IR, brachytherapy) enables precise dose delivery in irregular or curved sites [2]. This study evaluates oncologic results and late toxicity of IR in DTT HaN BCC. Material/Methods: Between November 2020 and December 2023, patients with histologically confirmed BCC were treated using high-dose-rate (HDR) or pulsed-dose- rate (PDR) IR, either interstitial or hybrid technique. All tumors met DTT EADO criteria. Patients were evaluated 4 weeks post-treatment and every 3–6 months. Tumor response, local control (LC), and late effects (RTOG/EORTC) were assessed clinically. Statistical analyses used Mann–Whitney U and chi- square tests (PQStat), with p < 0.05 significant. Results: A total of 29 patients (16 women, 13 men; mean age 71.9 years) with 30 lesions were included. Nineteen lesions received interstitial and eleven hybrid IR; HDR was used in 20 and PDR in 10 cases. According to EADO, 13 lesions were stage IIa and 17 IIIb. Lesion sites included periorbital (38.7%), nasal (29.0%), perioral (9.7%), buccozygomatic (9.7%), auricular (9.7%), and periauricular (3.2%) regions. By UICC/AJCC 8th edition, 19 lesions were T1, 4 T2, and 7 T3. Median total dose was 49.5 Gy (47.3–50) for PDR and 40 Gy (40–45) for HDR; median treatment duration was 4.2 and 5.3 days, respectively. Median follow-up was 21 months (6.4–43.6). All patients achieved complete response (100%), and LC at last follow-up was 97%, with one recurrence successfully salvaged using HDR IR. The Kaplan-Meier estimated 2-year LC rate was 97% (Figure 1). Late G1 reactions (erythema, pigmentation, atrophy) occurred in 43.3%, G2 (telangiectasia) in 13.3%, and G4 (ulceration) in 6.7%; one ulcer healed spontaneously, another required prolonged care. No significant correlation was found between dosimetric parameters (CTV, V150, V200), technique (HDR vs PDR), or stage and late effects (G ≥ 2). Although patients with more pronounced reactions were younger (mean 60 vs 79 years, p < 0.05), this likely reflected the small cohort rather than a biological factor. Facial and functional integrity were preserved in all cases.
Conclusion: Interstitial and hybrid IR achieved excellent local control and preserved function and appearance in DTT HaN BCC. This safe, effective, organ-preserving approach represents a valuable alternative to surgery in complex locations. Keywords: functional preservation References: 1. Peris K, Fargnoli MC, Kaufmann R et al.; EADO”A, EDF”B, ESTRO”C, UEMS”D and EADV”E. European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma- update 2023. Eur J Cancer. 2023 Oct;192:113254. doi: 10.1016/j.ejca.2023.113254. Epub 2023 Jul 28. PMID: 37604067.2. Brovchuk S, Shepil Z, Venkat P et.al. High dose rate brachytherapy for lip cancer with interstitial, surface, or a combination of interstitial and surface mold technique. Brachytherapy. 2025 Jan-Feb;24(1):68- 75. doi: 10.1016/j.brachy.2024.09.004. Epub 2024 Oct 19. PMID: 39428309. Clinical Outcomes, Toxicity, and Cosmetic Results of HDR Plesiotherapy for Non-Melanoma Skin Cancer Alice Manuela Alves 1,2 , Luisa Samarão 3 , Alexandre Pereira 4,5 , Sara Pinto 4,6 , Pedro Fernandes 7 , Lurdes Trigo 7 1 Radiation Oncology, São João University Hospital Center, Porto, Portugal. 2 University, University Vigo, Vigo, Spain. 3 Brachytherapy Service, Portuguese Oncology Institute of Porto, Porto, Portugal. 4 Medical Physics, Portuguese Oncology Institute of Porto, Porto, Portugal. 5 Medical Physics, Radiobiology and Radiation Protection Group, Portuguese Oncology Institute of Porto, Porto, Portugal. 6 Medical Physics, Radiobiology and Radiation Protection Group, Portuguese Oncology Institute of Porto Oncology Institute of Porto, Porto, Portugal. 7 Brachytherapy Service, Portuguese Digital Poster 2729
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