title: Interstitial high-dose-rate brachytherapy in eyelid cancer.
abstract: OBJECTIVE
  To report the experience and the outcomes of interstitial high-dose-rate (HDR) brachytherapy (BT) of eyelid skin cancer at the Department of Radiotherapy of Hospital de Santa Maria in Lisbon.
  
  
  METHODS
  Seventeen patients (pts; mean age, 73.75 years) who underwent eyelid interstitial HDR BT with an (192)Ir source between January 2011 and February 2013 were analyzed. Lesions were basal (94%) and squamous (6%) cell carcinomas, on lower (88%) or upper (6%) eyelids, and on inner canthus (6%). T-stage was Tis (6%), T1 (46%), T2 (36%), and T3a (12%). The purpose of BT was radical (12%), adjuvant to surgery (71%), or salvage after surgery (18%). The BT implant and treatment planning were based on the Stepping Source Dosimetry System. The median total dose was 42.75 Gy (range, 32-50 Gy), with a median of 10 fractions (range, 9-11 fractions), twice daily, 6 h apart. The median V100 was 2.38 cm(3) (range, 0.83-5.59 cm(3)), and the median V150 was 1.05 cm(3) (range, 0.24-3.12 cm(3)).
  
  
  RESULTS
  At a median followup of 40 months (range, 7-43 months), the local control was 94.1%. There was one local recurrence and one non-related death. The BT was well tolerated. Madarosis was the most common late effect (65% of pts) and was related with higher values of V100 (p = 0.027). Cosmetic outcomes were good and excellent in 70% of pts.
  
  
  CONCLUSIONS
  Interstitial HDR BT is a feasible and safe technique for eyelid skin cancers, with good local control. Recurrent lesions and higher volumes receiving the prescribed dose were associated with worse outcomes.
authors.affiliation: Department of Radiotherapy, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon, Portugal. Electronic address: virginiacmareco@gmail.com.
authors.forename: Virgínia
authors.initials: V
authors.lastname: Mareco
authors.affiliation: Department of Radiotherapy, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon, Portugal; Service de Radiothérapie, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique.
authors.forename: Laurentiu
authors.initials: L
authors.lastname: Bujor
authors.affiliation: Department of Radiotherapy, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon, Portugal.
authors.forename: André N
authors.initials: AN
authors.lastname: Abrunhosa-Branquinho
authors.affiliation: Department of Radiotherapy, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon, Portugal.
authors.forename: Miguel Reis
authors.initials: MR
authors.lastname: Ferreira
authors.affiliation: Medical Physics Unit, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon, Portugal.
authors.forename: Tiago
authors.initials: T
authors.lastname: Ribeiro
authors.affiliation: Department of Radiotherapy, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon, Portugal.
authors.forename: Ana Luisa
authors.initials: AL
authors.lastname: Vasconcelos
authors.affiliation: Ophtalmology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon, Portugal.
authors.forename: Cidalina Reis
authors.initials: CR
authors.lastname: Ferreira
authors.affiliation: Department of Radiotherapy, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon, Portugal.
authors.forename: Marília
authors.initials: M
authors.lastname: Jorge
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods*; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D019583:Dose Fractionation, Radiation; D005142:Eyelid Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D018714:Radiotherapy, Adjuvant; D016879:Salvage Therapy; D016896:Treatment Outcome
chemical_list: D007496:Iridium Radioisotopes
keywords: Eyelid; HDR; Interstitial high-dose-rate brachytherapy; Skin cancer