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8: Skin Brachytherapy




  • Likhacheva, Anna O.
  • Devlin, Phillip M.
  • Buzurovic, Ivan M.


In current practice, radiation therapy has become an effective therapy for malignancies of the skin, including non-melanoma skin cancer (NMSC), cutaneous lymphoma, Kaposi sarcoma, Merkel cell carcinoma, and others. Various radiation therapy techniques have been developed to treat cutaneous malignancies. These include electron beams, superficial X-rays, orthovoltage X-rays, megavoltage photons, and high dose rate (HDR) brachytherapy. Skin brachytherapy is well suited to select patients for anatomic, medical, and logistical reasons. In fact, skin brachytherapy can offer dosimetric advantages over external beam radiation therapy when targeting extensive cutaneous lymphomas or those in challenging anatomic locations. Leipzig and Valencia applicators are the simplest way to deliver skin brachytherapy. This chapter presents clinical workflows for treatment using flap applicators such as the Freiburg Flap, end Catheter Flap Set, and custom-made applicators. In addition to dosimetric advantages, skin brachytherapy is appealing from the standpoint of health economics.