Fractionated high dose rate brachytherapy moulds - a precise treatment forcarcinoma of the pinna

Background and purpose: The aim of this paper is to describe a fractionated high dose rate brachytherapy procedure for the treatment of small superfic ial cancers of the pinna and to report the outcome in a small series of pat ients. Materials and methods: Thirteen patients with superficial cancers of the pi nna, nor invading cartilage, have been treated and in the majority of cases the tumour thickness was determined by a transdermal ultrasound measuremen t. For the single-plane moulds the prescribed surface dose was 45 Gy in eig ht fractions over 5 days and the moulds were constructed such that the full thickness of the disease, as determined by the ultrasound measurement, wou ld lie within the 80% isodose surface. One case was treated with a sandwich mould and in this case the dose was reduced to 42.5 Gy. The treatment mach ine was a high dose rare microselectron, which contains a single stepping i ridium source. Results: The radiation reactions were of moderate severity, but were limite d to the high dose volume. In all cases there was complete tumour resolutio n and rapid healing occurred leaving a barely perceptible scar. There were no recurrences over a minimum follow-up time of 18 months and there were no late radiation complications in this period. Conclusions: The treatment of superficial carcinoma of the pinna by means o f HDR moulds is a safe and reliable technique. In this small series of pati ents there was total tumour control with excellent cosmesis. (C) 1998 Elsev ier Science Ireland Ltd. All rights reserved.