Epidermal Radionuclide Therapy: Dermatological High-Dose-Rate Brachytherapy for the Treatment of Basal and Squamous Cell Carcinoma

Abstract

Non-melanocytic skin cancer (NMSC) is the most frequent malignancy among populations of European origin, and in some countries it accounts for about half of all tumours. In the present paper a therapeutic option for the treatment of Basal CellCell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC) is described. It basically consists in a superficial high dose brachytherapy, characterised by the use of radioactive beta emitting isotopes, incorporated in a specially formulated inert, synthetic resin, which is applied on the surface of skin tumours. The electrons from high energy (> 1MeV) beta emitters isotopes deposit more than 90 % of the dose to the first 2 mm of the skin, which is the depth usually interested from tumour invasion, but spare the deeper tissues from irradiation. The therapy has been used in a large variety of BCC and SCC: tumours of very large sizes, relapsing or recurrent forms, multifocal lesions, without restriction of site, dimension, clinical or histological type, patients clinical situation. A complete response was obtained in 95% of the treated lesions, and in 84 % of the lesions after a single application. A clear advantage of the proposed nuclear medicine therapeutic treatment with respect to the surgery is especially evident for all the tumours located in difficult sites, on which surgery would be difficult (nose, ears) or would produce functional mutilations (penis, vulva, eyelids)