title: Postoperative interstitial brachytherapy in eyelid cancer: long term results and assessment of Cosmesis After Interstitial Brachytherapy scale.
abstract: OBJECTIVE
  To analyse feasibility and safety of postoperative interstitial brachytherapy (IBRT) in patients of eyelid cancer treated primarily by surgical excision.
  
  
  METHODS
  In this series, 8 patients with eyelid cancer were treated using postoperative interstitial brachytherapy. Patients were followed up for local control, cosmetic outcome, and acute and late toxicities. Cosmetic outcome was measured using a 6 point indigenous Cosmesis After Interstitial Brachytherapy (CAIB) scale.
  
  
  RESULTS
  The patients were between 23-82 years (median: 71 years). There were 3 females and 5 males, and 3 patients had lesions in upper eyelid. Postoperative high-dose-rate brachytherapy was used in all with 2 catheters implanted in most of them (6 out of 8). Local control was calculated from end of treatment to last follow-up. At last follow-up, all patients remained locally controlled. Two patients had nodal recurrence 6 months after interstitial brachytherapy and were salvaged effectively by external beam radiotherapy. At last follow-up, 7 patients were loco-regionally controlled and one was lost to follow up. All patients had Radiation Therapy Oncology Group (RTOG) grade 1 acute toxicity and 2 had grade 1 Common Terminology Criteria for Adverse Events (CTCAE) version.3 late toxicities. The cosmesis score for the whole group ranged between 0-1 indicating excellent to very good cosmesis.
  
  
  CONCLUSIONS
  Postoperative high-dose-rate brachytherapy resulted in excellent disease control and cosmesis without significant acute or late toxicities. It is an effective modality for treatment of eyelid cancers in selected patients. Future prospective studies with the validation of CAIB scale would give us more insight to this effective yet often ignored modality of IBRT.
authors.affiliation: Department of Radiation Oncology, Tata Memorial Hospital.
authors.forename: Sarbani Ghosh
authors.initials: SG
authors.lastname: Laskar
authors.affiliation: Department of Radiation Oncology, Tata Memorial Hospital.
authors.forename: Trinanjan
authors.initials: T
authors.lastname: Basu
authors.affiliation: Department of Medical Physics, Tata Memorial Hospital.
authors.forename: Suresh
authors.initials: S
authors.lastname: Chaudhary
authors.affiliation: Department of Surgical Oncology, Tata Memorial Hospital.
authors.forename: Devendra
authors.initials: D
authors.lastname: Chaukar
authors.affiliation: Department of Head and Neck Surgery, Kokilaben Dhirubai Ambani Hospital, Mumbai, India.
authors.forename: Mandar
authors.initials: M
authors.lastname: Nadkarni
authors.affiliation: Department of Radiation Oncology, Tata Memorial Hospital.
authors.forename: Manjunatha
authors.initials: M
authors.lastname: Gn
keywords: brachytherapy; cosmesis; eyelid cancer; toxicities
references.citation: Br J Ophthalmol. 1976 Dec;60(12):794-805
references.pmid: 1009061
references.citation: Am J Surg. 1972 Oct;124(4):522-6
references.pmid: 5076167
references.citation: Clin Exp Ophthalmol. 2011 Jan;39(1):65-83; quiz 92-3
references.pmid: 21040309
references.citation: Surv Ophthalmol. 1986 May-Jun;30(6):349-65
references.pmid: 3523806
references.citation: Med Phys. 1999 Feb;26(2):119-52
references.pmid: 10076966
references.citation: Br J Plast Surg. 1993 Oct;46(7):599-606
references.pmid: 8252270
references.citation: Curr Oncol. 2014 Apr;21(2):e326-9
references.pmid: 24764714
references.citation: Int J Radiat Oncol Biol Phys. 1995 Mar 30;31(5):1123-39
references.pmid: 7713778
references.citation: Int J Radiat Oncol Biol Phys. 2005 Nov 1;63(3):753-7
references.pmid: 15927410
references.citation: J Contemp Brachytherapy. 2013 Mar;5(1):45-9
references.pmid: 23634155
references.citation: Ophthalmology. 2001 Nov;108(11):2088-98; quiz 2099-100, 2121
references.pmid: 11713084
references.citation: Cancer. 2008 Jan 1;112(1):111-8
references.pmid: 17963262
references.citation: Brachytherapy. 2007 Jul-Sep;6(3):227-9
references.pmid: 17681245
references.citation: Int J Radiat Oncol Biol Phys. 2011 Mar 1;79(3):650-9
references.pmid: 21281895
references.citation: Strahlenther Onkol. 2014 Mar;190(3):245-9
references.pmid: 24424628
references.citation: Int J Radiat Oncol Biol Phys. 2004 Aug 1;59(5):1326-9
references.pmid: 15275716
references.citation: Br J Cancer. 1997;76(1):100-6
references.pmid: 9218740
references.citation: Int J Radiat Oncol Biol Phys. 1994 Nov 15;30(4):775-80
references.pmid: 7960978
references.citation: Jpn J Ophthalmol. 2014 Jul;58(4):327-33
references.pmid: 24763914
references.citation: J Cancer Res Ther. 2011 Apr-Jun;7(2):157-61
references.pmid: 21768703
references.citation: J Skin Cancer. 2014;2014:858636
references.pmid: 24864212
references.citation: Ophthal Plast Reconstr Surg. 2008 Nov-Dec;24(6):444-9
references.pmid: 19033839
references.citation: Ophthal Plast Reconstr Surg. 1994 Sep;10(3):153-9
references.pmid: 7947441
references.citation: Ophthalmology. 2004 Apr;111(4):617-23
references.pmid: 15051191