HDR Brachytherapy with Customized Molds for Facial Skin Lesions

HDR Brachytherapy is an interesting alternative treatment for skin cancer since it offers shorter overall treatments times with good cosmetic outcomes. For facial skin lesions (nose, ear, eyelid…), it is necessary to design a personalized mold that adapts to curved or irregular surfaces and ensures precise treatment delivery. In this study, we develop a method using thermoplastic mask and dental wax in which the catheters are embedded to allow an ideal and perfectly reproducible position during the entire treatment. We describe the whole process of treatment preparation, 3D planning with Oncentra Brachy® planning system, quality controls and treatment with an Elekta Flexitron® remote afterloader. For the 10 patients involved, the treatment was easy to plan, comfortable for the patient and the staff, and had excellent re-position in every application. HDR brachytheray treatments offer highly effective results in terms of local control and could be a standard method for skin treatments in the future.