RADIOACTIVE PATCH FOR BASAL CELL CARCINOMA 

July 21, 2012 (Miami Beach, Florida) — Basal cell carcinoma, the most common type of skin cancer, can be effectively treated with a radioactive skin patch containing phosphorus 32, researchers said here at the SNM 2012 Annual Meeting.

The new skin patch treatment "opens a new dimension in the field of therapeutic nuclear medicine and dermatology, especially for the treatment of skin malignancies," senior author Rakesh Kumar, MD, PhD, from All India Institute of Medical Sciences in New Delhi, told Medscape Medical News.

Dr. Kumar and colleagues treated 10 patients (5 men and 5 women), ranging in age from 32 to 74 years. All participants had histopathologically proven unifocal basal cell carcinoma on the face.

Five of the patients had lesions that were close to the eyes, 4 had a lesion on the nose, and 1 had a lesion on the forehead. None had invasion of underlying structures.

The sealed patches incorporating phosphorus 32 (as phosphoric acid) were custom-made according to the size and shape of the lesions. They were applied locally on the tumor site on day 1, day 4, and day 7 for 3 hours each day. The patches delivered approximately 100 Gy of radiation dose superficially. All treatments were done on an outpatient basis.

Biopsies were taken from the center and margins of the lesions at 3 and 6 months, and then at 1, 2, and 3 years after patch application to test for efficacy.

The biopsies were all negative from both the center and margins of the tumors at 3 months in all patients. However, a biopsy done at 6 months revealed basal cell carcinoma in 2 of the 10 patients. One patient had residual disease, the other had a recurrence.

The biopsies of the other 8 patients showed that they were completely free of disease after approximately 3 years of follow-up, Dr. Kumar reported. In addition, there was no toxicity, and the minimal scarring that occurred at the tumor site gradually healed, he said.

"The patch contains a radioisotope, and the beta rays have a range of around 2 to 3 mm. These skin cancers are usually superficial, so it radiates to this depth with this beta ray, and this acts like external beam radiation therapy and kills the tumor," he told Medscape Medical News.

"There are no side effects, since with this range, it is not going to affect normal organs," he added.

Dr. Kumar said that his group is treating more patients now and will continue accruing more patients to further test the efficacy of the radioactive skin patch in basal cell carcinoma.

Elegant in Its Simplicity

Norman LaFrance, MD, an independent consultant in Leesburg, Virginia, called the study "elegant in its simplicity."

"Although basal cell carcinoma is the least onerous of the skin cancers, it is fairly common, and if you live long enough you are going to get it. You can usually be cured by surgery, and that continues to be the treatment of first choice," Dr. LaFrance told Medscape Medical News.

"But since it is a cancer due to sun exposure, not surprisingly, it presents on the hands and the face, and the issue becomes one of removal, especially if the cancer is located around the eyes, nose, ears, or other sensitive areas. In that case, you have the potential for very disfiguring surgery," Dr. LaFrance said.

"If you now have an option, particularly on anatomically challenging areas, for a cure, even though surgery is your first choice, you're probably going to choose the less invasive option," he added.

"More importantly, Dr. Kumar confirmed that it was a good treatment option with essentially zero toxicity. The follow-up time was more than 3 years, and there was no recurrence. It is an elegant alternative to surgery, so you can avoid disfiguring surgery, and it's an easy application with virtually no toxicity and very good posttherapy healing," Dr. LaFrance noted.

Dr. Kumar and Dr. LaFrance have disclosed no relevant financial relationships.

SNM 2012 Annual Meeting: Abstract 62. Presented June 10, 2012.