Esteya®Electronic HDR X-ray Brachytherapy for Basal and Squamous Cell Skin Cancer: Early Clinical Outcomes from a Multi-Center Study

Purpose | Radiation therapy can be a primary treatment option for nonmelanoma skin cancer (NMSC) when function, cosmesis or patient preference makes surgery unattainable. 1 The use of isotope-based radiation therapy, particularly high-dose rate (HDR) brachytherapy, has shown to be an effective treatment option for NMSC with local control varying between 72- 98%. 2 Recently, low energy electronic X-ray Brachytherapy (EBTx) has been used to treat NMSC. EBTx is HDR treatment making hypofractionation possible and requires minimal shielding. Esteya® (Elekta AB, Stockholm, Sweden), a new FDA-cleared EBTx device for the treatment of NMSC, is a 69.5 kV device with a sharp penumbra and Surface-Skin Distance of <6 cm (orthovoltage is >/=15 cm). This report assesses the feasibility of EBTx for the treatment of NMSC, patient characteristics, and early outcomes (local tumor control and acute toxicity).

Materials and Methods | U.S. patients at three clinical sites started Esteya® EBTx treatment in January 2014 with the final patient for this report completing in October 2014. A retrospective chart review of 75 patients, with a total of 86 lesions, showed patients received a total radiation therapy dose of 45 to 50 Gy in 8 to 10 fractions (three different variations), delivered twice weekly (each fraction spaced by at least 2 days). This analysis included patient demographics, lesion size, histopathology, local control
and toxicities at various follow-up times.