{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:16:22Z","timestamp":1760058982704,"version":"build-2065373602"},"reference-count":29,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: High-dose-rate (HDR) interventional radiotherapy (IRT) represents a valuable treatment alternative for basal cell carcinoma (BCC) of the midface, especially in the presence of esthetic or functional issues related to surgery. This retrospective study examines the clinical outcomes of patients who underwent HDR-IRT at our institution. Methods: Patients (pts) with histologically confirmed midface BCC were treated with HDR-IRT using superficial, interstitial, or endocavitary implants depending on tumor characteristics. Fractionation regimens were tailored to tumor location: 45 Gy in 9 fractions twice a day (the cheeks\/lips) and 44 Gy in 14 fractions (the nose, with the first and last fractions delivering 4 Gy each, administered once daily, and the remaining 12 fractions delivering 3 Gy each, administered twice daily (BID) with an inter-fraction interval of at least 6 h). Treatment efficacy was assessed based on local control rates, toxicity (CTCAE criteria), and cosmetic outcomes. Results: Eight patients were considered. The most common tumor site was the nose (seven patients, 87.5%), followed by the upper lip. Tumors were either primary (three patients, 37.5%) or residual\/recurrent after previous surgery with involved margins (five patients, 62.5%). The median follow-up was 6 months (range: 1\u201319 months). Clinical local control was achieved in all cases, with persistent alteration at dermoscopy in one patient six months after the completion of treatment. Acute toxicities were minimal, with two patients developing grade 3 skin toxicity, which resolved within 1\u20133 months with topical management. Cosmetic outcomes were favorable across all patients. Conclusions: HDR-IRT is a well-tolerated, effective, and cosmetically favorable treatment for midface BCC. Our institutional experience supports its use as an alternative to surgery in cosmetically sensitive areas and in selected patients\/lesions unfit for surgery. Endocavitary implants appear to be an effective option to cover the full thickness nasal wall without resorting to interstitial implants.<\/jats:p>","DOI":"10.3390\/jcm14103305","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T08:20:23Z","timestamp":1746778823000},"page":"3305","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preserving Esthetics: Interventional Radiotherapy (Brachytherapy) as a Potential Alternative to Surgery for Basal Cell Carcinoma of the Midface"],"prefix":"10.3390","volume":"14","author":[{"given":"Alessia","family":"Re","sequence":"first","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07100 SassariOlbia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6800-9023","authenticated-orcid":false,"given":"Sebastiana","family":"Lai","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Azienda Ospedaliera Universitaria, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenda","family":"Mantione","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Azienda Ospedaliera Universitaria, 07100 Sassari, Italy"},{"name":"Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9194-620X","authenticated-orcid":false,"given":"Andrea","family":"D\u2019Aviero","sequence":"additional","affiliation":[{"name":"Department of Medical, Oral and Biotechnological Sciences, \u201cG. D\u2032Annunzio\u201d University of Chieti, 66100 Chieti, Italy"},{"name":"Department of Radiation Oncology, \u201cS.S. Annunziata\u201d Chieti Hospital, 66100 Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"Sanna","sequence":"additional","affiliation":[{"name":"Division of Radiotherapy, Azienda Ospedaliera Universitaria, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Pilloni","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07100 SassariOlbia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0556-3593","authenticated-orcid":false,"given":"Sebastiano","family":"Menna","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07100 SassariOlbia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danila","family":"Piccari","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07100 SassariOlbia, Italy"},{"name":"Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Policlinico Universitario \u201cA. Gemelli\u201d IRCCS, 00100 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Althea","family":"Boschetti","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07100 SassariOlbia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3368-1810","authenticated-orcid":false,"given":"Bruno","family":"Fionda","sequence":"additional","affiliation":[{"name":"Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Policlinico Universitario \u201cA. Gemelli\u201d IRCCS, 00100 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Porru","sequence":"additional","affiliation":[{"name":"Otolaryngology, Mater Olbia Hospital, 07026 Olbia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9945-0658","authenticated-orcid":false,"given":"Pierangela","family":"Tramaloni","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Azienda Ospedaliera Universitaria, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Gallus","sequence":"additional","affiliation":[{"name":"Otolaryngology, Mater Olbia Hospital, 07026 Olbia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Tagliaferri","sequence":"additional","affiliation":[{"name":"Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Policlinico Universitario \u201cA. Gemelli\u201d IRCCS, 00100 Rome, Italy"},{"name":"Radiotherapy Department, Universit\u00e0 Cattolica del Sacro Cuore, 00100 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Antonietta","family":"Montesu","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy"},{"name":"Dermatology Division, Azienda Ospedaliera Universitaria, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2410-6083","authenticated-orcid":false,"given":"Corrado","family":"Rubino","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy"},{"name":"Division of Plastic Surgery, Azienda Ospedaliera Universitaria, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6261-2772","authenticated-orcid":false,"given":"Francesco","family":"Bussu","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Azienda Ospedaliera Universitaria, 07100 Sassari, Italy"},{"name":"Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gian Carlo","family":"Mattiucci","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mater Olbia Hospital, 07100 SassariOlbia, Italy"},{"name":"Radiotherapy Department, Universit\u00e0 Cattolica del Sacro Cuore, 00100 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1111\/1753-6405.12470","article-title":"Cancers in Australia attributable to exposure to solar ultraviolet radiation and prevented by regular sunscreen use","volume":"39","author":"Olsen","year":"2015","journal-title":"Aust. 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