Optimized penile surface mold brachytherapy using latest stereolithography techniques: A single-institution...

Area of Science:

• Oncology
• Radiation Oncology
• Urology

Background:

• Squamous cell carcinoma of the penis is a rare malignancy.
• High-dose-rate (HDR) brachytherapy is an effective treatment modality for localized cancers.
• Developing precise and patient-specific brachytherapy applicators is crucial for optimal dose delivery.

Purpose of the Study:

• To describe a novel technique for penile surface mold high-dose-rate (HDR) brachytherapy.
• To report early outcomes and toxicities associated with this technique.

Main Methods:

• A penile surface mold HDR brachytherapy technique was developed using dental alginate impressions and CT imaging.
• Custom applicators were designed using computer-assisted methods for precise catheter placement.
• Five patients with T1aN0 penile squamous cell carcinoma were treated with 40 Gy in 10 fractions.

Main Results:

• All patients tolerated the outpatient procedure well with minimal discomfort.
• Acute Grade 2 skin reactions were observed, resolving to late Grade 1 toxicities.
• Median follow-up was 35 months; one patient developed urethral stricture, and two experienced local recurrence.

Conclusions:

• Penile surface mold HDR brachytherapy is a repeatable, accurate, and well-tolerated outpatient procedure.
• This technique shows promise for treating penile cancer, but requires further validation in larger studies with longer follow-up.