S109
Brachytherapy - Head & neck, skin, eye
ESTRO 2026
same CT datasets using a Halcyon accelerator, with a 4mm PTV margin and the mould as bolus. Results: Between June 2011 and February 2025, 37 patients were treated with surface mould HDR brachytherapy. Tumor locations were frontal (n=11), parietal (n=15), temporal (n=5), and occipital (n=6). Median age was 79 years [IQR 65–86]; 28 patients (76%) were men, and 32 (86%) had a WHO performance status of 0–1. Twenty- five patients (68%) received adjuvant brachytherapy after surgery (15 R0, 10 R1) and 12 were treated definitively after biopsy. Histological subtypes mainly included sarcoma (n = 15) and basal cell carcinoma (n = 12).[JS1] The median number of catheters per mould was 10 [IQR 8–13]. Median follow-up was 21 months [IQR 8–41]. Eleven recurrences occurred (4 local, 7 distant). Acute grade ≥ 2 toxicities included 9 cases of dermatitis, 2 telangiectasias, 16 cases of alopecia, and 1 depigmentation. Dosimetric comparison between HDR brachytherapy and VMAT is ongoing, with preliminary analyses focused on brain sparing and target coverage. Conclusion: Surface mould HDR brachytherapy is a safe and effective option for scalp skin tumors, offering high local control and excellent cosmetic results in elderly patients. It can be used both definitively and adjuvantly. The ongoing dosimetric comparison with VMAT will clarify their respective roles, particularly concerning brain sparing and dose conformity. Keywords: Surface brachytherapy - Scalp skin tumors References: Boman EL, Paterson DB, Pearson S, Naidoo N, Johnson C. Dosimetric comparison of surface mould HDR brachytherapy with VMAT. J Med Radiat Sci. déc 2018;65(4):311 - 8.Wills RJ, Lowe G, Jones CL, Hoskin PJ. Dosimetric comparison of volumetric modulated arc therapy (VMAT) and high-dose-rate brachytherapy (HDR-BT) for superficial skin irradiation with significant curvature in one or more planes. Strahlenther Onkol. juin 2021;197(6):547 - 54.Major T, Fröhlich G, Ágoston P, Polgár C, Takácsi-Nagy Z. The value of brachytherapy in the age of advanced external beam radiotherapy: a review of the literature in terms of dosimetry. Strahlenther Onkol. févr 2022;198(2):93 - 109.
Further randomized studies are warranted to evaluate clinical outcomes compared to standard of care. Keywords: Intracranial Permanent Brachytherapy,
Glioblastoma References:
1. Turner AC, Abbott EM, Garcia MA, Patel S, Johnson KM, Brachman DG. A biologically effective dose-based framework for integrating LDR brachytherapy and EBRT in glioblastoma treatment. Brachytherapy. 2025 Nov-Dec;24(6):949- 960.https://doi.org/10.1016/j.brachy.2025.07.0032. Yekula, A., Gessler, D.J., Ferreira, C. et al. GammaTile® (GT) as a brachytherapy platform for rapidly proliferating glioblastomas: from case series to clinical trials. J Neurooncol 166, 441–450 (2024). https://doi.org/10.1007/s11060-023-04545-7 Digital Poster 4897 Surface Brachytherapy versus VMAT for Scalp Skin Tumors: A Dosimetric Comparison Céline Meyer 1 , Nicolas Demogeot 1 , Julia Salleron 2 , Sandrine Huger 3 , Sébastien Cambier 2 , Fabien Richard 4 , Justine Bisson 4 , Marie Paillard 4 , Sophie Renard 1 1 Radiation department, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France. 2 Biostatistics, Institut de Cancérologie de Lorraine, Vandœuvre-lès- Nancy, France. 3 Medical physics department, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France. 4 Dosimetry department, Centre hospitalier Emile Durkheim, Epinal, France Purpose/Objective: Surgical excision is the standard treatment for cutaneous tumors of the face and scalp, but radiotherapy is a validated alternative when surgery is contraindicated or potentially mutilating. Surface HDR brachytherapy offers favorable dosimetry for small lesions and provides excellent local control with high cosmetic and functional outcomes. However, comparative dosimetric data between external beam radiotherapy and surface brachytherapy for scalp tumors remain limited. Our study aimed to highlight the advantages of surface brachytherapy over VMAT for scalp skin tumors, focusing on brain sparing. Material/Methods: This single-center retrospective dosimetric study (2011–2025) included patients with scalp cutaneous carcinoma (T1–T3 N0 M0), treated with surface mould HDR brachytherapy, either as definitively or postoperatively. Custom moulds with catheters were used, and all patients underwent CT simulation (2-mm slices) with thermoplastic immobilisation. CTV included a 1-2 cm margin and 3mm depth. Prescribed dose ranged from 25–30 Gy in 5–6 fractions. Comparative VMAT plans will be retrospectively created on the
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