title: Aspects of dosimetry and clinical practice of skin brachytherapy: The American Brachytherapy Society working group report.
abstract: OBJECTIVE
  Nonmelanoma skin cancers (NMSCs) are the most common type of human malignancy. Although surgical techniques are the standard treatment, radiation therapy using photons, electrons, and brachytherapy (BT) (radionuclide-based and electronic) has been an important mode of treatment in specific clinical situations. The purpose of this work is to provide a clinical and dosimetric summary of the use of BT for the treatment of NMSC and to describe the different BT approaches used in treating cutaneous malignancies.
  
  
  METHODS
  A group of experts from the fields of radiation oncology, medical physics, and dermatology, who specialize in managing cutaneous malignancies reviewed the literature and compiled their clinical experience regarding the clinical and dosimetric aspects of skin BT.
  
  
  RESULTS
  A dosimetric and clinical review of both high dose rate ((192)Ir) and electronic BT treatment including surface, interstitial, and custom mold applicators is given. Patient evaluation tools such as staging, imaging, and patient selection criteria are discussed. Guidelines for clinical and dosimetric planning, appropriate margin delineation, and applicator selection are suggested. Dose prescription and dose fractionation schedules, as well as prescription depth are discussed. Commissioning and quality assurance requirements are also outlined.
  
  
  CONCLUSIONS
  Given the limited published data for skin BT, this article is a summary of the limited literature and best practices currently in use for the treatment of NMSC.
authors: Department of Radiation Oncology, Lynn Cancer Institute, Boca Raton, FL. Electronic address: Zouhib@brrh.com.
authors: Zoubir
authors: Z
authors: Ouhib
authors: Department of Radiation Oncology, Lynn Cancer Institute, Boca Raton, FL.
authors: Michael
authors: M
authors: Kasper
authors: Department of Radiation Oncology, Hospital La Fe, Valencia, Spain; Department of Radiation Oncology, Hospital Clinica Benidorm, Alicante, Spain.
authors: Jose
authors: J
authors: Perez Calatayud
authors: Department of Radiation Oncology, Hospital Clinica Benidorm, Alicante, Spain.
authors: Silvia
authors: S
authors: Rodriguez
authors: Department of Radiation Oncology, 21st Century Oncology Inc., Casa Grande, Arizona.
authors: Ajay
authors: A
authors: Bhatnagar
authors: Department of Radiation Oncology, Targeted Radiation Therapy Institute, Pleasanton, CA.
authors: Sujatha
authors: S
authors: Pai
authors: Department of Biochemistry, Florida Atlantic University College of Medicine, Boca Raton, FL; Department of Dermatology, Florida Atlantic University College of Medicine, Boca Raton, FL.
authors: John
authors: J
authors: Strasswimmer
mesh_terms: D001918:Brachytherapy / Q000295:instrumentation / Q000379:methods*; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000532:radiotherapy*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D006801:Humans; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D012878:Skin Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D012955:Societies, Medical; D014481:United States
keywords: Basal cell carcinoma; Biological equivalent dose; Clinical target volume; Electronic brachytherapy; Gross target volume; High dose rate; Ir-192; Nonmelanoma skin cancer; Planning target volume; Squamous cell carcinoma