aN (OTe) VI CONGRESSO SPRO Sociedade Portuguesa de Radioterapla Oncolégica rey ac Basal Cell Carcinoma (BCC) and Squamous Cell er Coo en na ete a tay nonmel eaten as sun-exposed areas of the skin such as nose, ears and lower lips.' The disease, when limited to the skin, can be successfully managed with local therapy (surgery and/or radiation).? However, these areas are often complex targets for ee et ee aes Ce eee as eR lesion and proximity to organs at risk (OAR)? Post-surgery recurrences or lesions with poor Peek ha) Bere dg cutie i aegis treatment technique that allows sparing deep structures and makes it possible to irradiate Cee ee eee ce eta ee eee areas can be precisely irradiated with small fields, Set ek a) Pee ee ett Cnet photons); and because smaller volumes tolerate higher doses, hypofractionation is possible.* ee ey we intend to show technical aspects Deeg ec ea Re eee cect DEUCE ac Tot) Seu cua sarcoma, BCC, SCC and locally recurrent breast Cee aR nS ee een aed method was identical to all lesions, although two Creed Cee ee eed ay Ses eG a Ree jons (I!) and large lesions of the thorax (4) AG eee) Seen eee es Pe am ee econ eae eee ns ee Coe UN eons prescription points, dose to the skin and doses to: the OAR.The dose was prescribed to points at Cen EI ae een Cee eee ea source. Eye shielding was used when necessary and the standard fractionation was 40 Gy in 10 Seen ered pe om eect ete eee ee ae ek Pee ee ere eatorN Cee areas) pce ee ed Pe Treatments ead aed Eyelid Ce HDR plesiotherapy in facial and thoracic skin lesions ALR Pinho*”, A. Pereira”, T-Viterbo"”, S. Pintol”, N. Stas”, L.Trigo®, |. Lencart'" ' Medical Physics Dept; Brachytherapy Dept; Radiotherapy Dept Instituto Portugués de Oncologia do Porto Procedures In the first technique (Fig 1A), the lesion was delineated with a radiopaque marker followed by the immobilization of the patient with a thermoplastic mask. Then a 2 mm bolus slab was laid on the mask and the plastic catheters were placed and immobilized with two bolus slabs. In the second technique (Fig 1B), after the delineation of the lesion with a radiopaque marker, bolus slabs were placed directly on the lesion and the plastic catheters were placed and fixed with two bolus slabs. In this technique, the limits of the mould were tattooed in the patient for reproducibility between fractions. The distance between catheters was always 10 mm. Results The maximum dose to the skin was always kept under 130 % of the prescribed dose (Fig 2).The doses to the OAR were converted to Biologically Effective Dose (BED) and Equivalent Dose in 2 Gy fractions (EQD2) and were always under their maximum tolerance dose. The dose verification results were accepted within a range of +10 % deviation of the planned dose to the prescribing points and to the skin (Fig 3). Dose varaton¢) Maxbosetome sian) Conclusions This technique showed to be a viable option to facial and thoracic non melanoma skin lesions. Due to the steep dose gradient of the 'Ir sources used in brachytherapy, adjacent healthy tissue and deep structures are spared, Furthermore, as masks and applicators are flexible, it is possible to treat lesions in irregular or curved surfaces assuring catheter fixation and treatment reproducibility between fractions