title: Efficacy and safety of electronic brachytherapy for superficial and nodular basal cell carcinoma.
abstract: OBJECTIVE
  Surface electronic brachytherapy (EBT) is an alternative radiotherapy solution to external beam electron radiotherapy and high-dose-rate radionuclide-based brachytherapy. In fact, it is also an alternative solution to surgery for a subgroup of patients. The objective of this work is to confirm the clinical efficacy, toxicity and cosmesis of a new EBT system, namely Esteya(®) in the treatment of nodular and superficial basal cell carcinoma (BCC).
  
  
  METHODS
  This is a prospective single-center, non-randomized pilot study to assess the efficacy and safety of EBT in nodular and superficial BCC using the Esteya(®) system. The study was conducted from June 2014 to February 2015. The follow up time was 6 months for all cases.
  
  
  RESULTS
  Twenty patients with 23 lesions were included. A complete response was documented in all lesions (100%). A low level of toxicity was observed after the 4(th) fraction in all cases. Erythema was the most frequent adverse event. Cosmesis was excellent, with more than 60% of cases without skin alteration and with subtle changes in the rest.
  
  
  CONCLUSIONS
  Electronic brachytherapy with Esteya(®) appears to be an effective, simple, safe, and comfortable treatment for nodular and superficial BCC associated with excellent cosmesis. It could be a good choice for elderly patients, patients with contraindications for surgery (due to comorbidities or anticoagulant drugs) or patients where surgery would result in a more disfiguring outcome. A longer follow-up and more studies are needed to confirm these preliminary results.
authors.affiliation: Dermatology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Ballester-Sánchez
authors.affiliation: Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: Pons-Llanas
authors.affiliation: Radiation Physics Department, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Cristian
authors.initials: C
authors.lastname: Candela-Juan
authors.affiliation: Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Celada-Alvarez
authors.affiliation: Dermatology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Blanca
authors.initials: B
authors.lastname: de Unamuno-Bustos
authors.affiliation: Pathology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Margarita
authors.initials: M
authors.lastname: Llavador-Ros
authors.affiliation: Radiology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ballesta-Cuñat
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, USA.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Barker
authors.affiliation: Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Tormo-Mico
authors.affiliation: Dermatology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Botella-Estrada
authors.affiliation: Radiation Physics Department, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Perez-Calatayud
keywords: basal cell carcinoma; electronic brachytherapy; skin brachytherapy; skin cancer