title: Brachytherapy in non melanoma skin cancer of eyelid: a systematic review.
abstract: OBJECTIVE
  Non melanoma skin cancers (NMSC) of eyelid are uncommon. Many treatments approach are available with surgery being considered as the gold standard. Radiotherapy is an effective alternative in patients unfit for surgery. Brachytherapy (BT) might be a better therapeutic option due high radiation dose concentration to the tumor and rapid dose fall-off resulting in normal tissues sparing. The aim of this review is to evaluate local control, toxicity, and functional cosmetic outcome of BT in NMSC of eyelid.
  
  
  METHODS
  A systematic search of the bibliographic databases PubMed, Scopus, and Cochrane Library from the earliest possible date through October 2015 was performed. Only studies published in English were included.
  
  
  RESULTS
  Six articles fulfilled the selection criteria and were included in our review. Due to high risk of bias, all studies were classified to provide a low level of evidence (according to Scottish Intercollegiate Guidelines Network Classification). No randomized controlled trials or case control studies were founded. Brachytherapy was well tolerated with acceptable toxicity and high local control rates (median: 95.2%). Functional and cosmetic outcome were reported in five study as acceptable good functional-cosmetic outcome (median: 100%).
  
  
  CONCLUSIONS
  To date, few evidences are available on the role of BT in eyelid NMSC, and they show satisfactory results in terms of local control and functional cosmetic outcome. Therefore, prospective controlled trials are justified.
authors.affiliation: Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine - DIMES, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Rezarta
authors.initials: R
authors.lastname: Frakulli
authors.affiliation: Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine - DIMES, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Galuppi
authors.affiliation: Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine - DIMES, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Cammelli
authors.affiliation: Radiation Oncology Unit, Research and Care Foundation 'Giovanni Paolo II', Catholic University of Sacred Heart, Campobasso, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Macchia
authors.affiliation: Radiation Oncology Unit, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
authors.forename: Simona
authors.initials: S
authors.lastname: Cima
authors.affiliation: Department of Radiation Oncology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Gambacorta
authors.affiliation: Department of Radiation Oncology, Istituti Ospitalieri, Cremona, Italy.
authors.forename: Ines
authors.initials: I
authors.lastname: Cafaro
authors.affiliation: Department of Radiation Oncology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Tagliaferri
authors.affiliation: Radiation Oncology Section, Santa Maria della Misericordia Hospital, Perugia, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Perrucci
authors.affiliation: Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine - DIMES, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Milly
authors.initials: M
authors.lastname: Buwenge
authors.affiliation: Radiation Oncology Unit, Bellaria Hospital, Bologna, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Frezza
authors.affiliation: Department of Radiation Oncology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Valentini
authors.affiliation: Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine - DIMES, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Alessio G
authors.initials: AG
authors.lastname: Morganti
keywords: brachytherapy; eyelid; non melanoma skin cancer; systematic review
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