Brachytherapy: an effective and safe treatment for skin cancer: evaluation of a large patient cohort in real-world clinical practice

Introduction
Skin cancers, although rarely metastatic or fatal, represent a significant clinical challenge. Surgery remains the most established and frequently used treatment modality, but comparable therapeutic outcomes can be achieved with radiotherapy. However, the role of radiotherapy – particularly brachytherapy – in the treatment of skin cancers is poorly described in the literature. There is a lack of prospective studies comparing the efficacy of these treatment methods.

Aim
Assessment of the efficacy and safety of brachytherapy for skin cancer.

Material and methods
An ambispective analysis included 215 patients with 236 lesions of epithelial skin cancers treated from 2015 to 2023, with a minimum of 1 year of follow-up after treatment.

Results
Complete remission was achieved in 93.2% of treated lesions. Treatment failure occurred in 6.8% of cases, including 0.8% of uncured lesions and 5.9% of recurrences, which were more common in squamous than basal cell carcinoma (p = 0.055). Variables such as age, sex, tumour size, location, total dose, and fractionation schedule had no significant impact on failure risk. One (0.4%) patient developed severe radiation-induced necrosis.

Conclusions
The high remission rate confirms brachytherapy as an effective skin cancer treatment regardless of the fractionation schedule used, offering excellent cosmetic and functional outcomes when properly applied.