(P119) Electronic Brachytherapy Management of Atypical Fibroxanthoma: Report of Seven Cases

April 30, 2015

This is the largest reported series of AFX treated with radiation therapy in the literature. No contraindication to the use of radiation is found in the literature. Prior series all utilized surgery, likely due to the clinically rapid progression of this tumor. Risk of recurrence is mitigated with surgical debulking prior to brachytherapy. Electronic brachytherapy appears to be a safe and effective treatment for AFX.

Stephen W. Doggett, MD; Aegis Oncology

PURPOSE: To evaluate the suitability of treating an uncommon skin malignancy, atypical fibroxanthoma (AFX), with electronic brachytherapy.

MATERIALS AND METHODS: From February 2013 to September 2014, we were referred a total of seven cases of AFX, all involving the scalp. All were treated with electronic brachytherapy 50 kV radiation (Xoft Inc., Fremont, California). All lesions received 40 Gy in two fractions per week; 5-mm margins were utilized.

RESULTS: As of October 2014, there has been one local recurrence, which was the only lesion that was not debulked surgically prior to electronic brachytherapy.

CONCLUSIONS: AFX is a rare skin cancer that is believed to be of mesenchymal origin, likely histiocytic. A less likely possibility is that it is derived from dedifferentiated squamous cell cancer. This is the largest reported series of AFX treated with radiation therapy in the literature. No contraindication to the use of radiation is found in the literature. Prior series all utilized surgery, likely due to the clinically rapid progression of this tumor. Risk of recurrence is mitigated with surgical debulking prior to brachytherapy. Electronic brachytherapy appears to be a safe and effective treatment for AFX.

Proceedings of the 97th Annual Meeting of the American Radium Society - americanradiumsociety.org