Comparative dosimetric findings using accelerated partial breast irradiation across five catheter subtypes

Radiation Oncology

Robert L. Hong¹  Mami Martin¹  Molly Sebastian¹  Stephanie Akbari¹  Virginia Lorio¹  Huaying Ji¹  Nadim M. Nasr¹  Zaker Rana¹ 

[1] Department of Radiation Oncology, Virginia Hospital Center, 1701 N George Mason Dr, Arlington 22205, VA, USA

关键词: Savi;    Contura;    Mammosite;    brachytherapy;    APBI;   

Others  :  1228485
DOI  :  10.1186/s13014-015-0468-7

 received in 2015-03-28, accepted in 2015-07-17,  发布年份 2015

【 摘 要 】

Purpose

Accelerated partial breast irradiation (APBI) with balloon and strut adjusted volume implants (SAVI) show promising results with excellent tumor control and minimal toxicity. Knowing the factors that contribute to a high skin dose, rib dose, and D ₉₅coverage may reduce toxicity, improve tumor control, and help properly predict patient outcomes following APBI.

Methods and materials

A retrospective analysis of 594 patients treated with brachytherapy based APBI at a single institution from May 2008 to September 2014 was grouped by applicator subtype. Patients were treated to a total of 34 Gy (3.4 Gy x 10 fractions over 5 days delivered BID) targeting a planning target volume (PTV) 1.0 cm beyond the lumpectomy cavity using a high dose rate source.

Results

SAVI devices had the lowest statistically significant values of D _max Skin (81.00 ± 29.83), highest values of D ₉₀(101.50 ± 3.66), and D ₉₅(96.09 ± 4.55). SAVI-mini devices had the lowest statistically significant values of D _max Rib (77.66 ± 32.92) and smallest V ₁₅₀(18.01 ± 3.39). Multi-lumen balloons were able to obtain the smallest V ₂₀₀(5.89 ± 2.21). Strut-based applicators were more likely to achieve a D _max Skin and a D _max Rib less than or equal to 100 %. The effect of PTV on V ₁₅₀showed a strong positive relationship (p < .001). PTV and D _max Skin showed a weak negative relationship in multi-lumen applicators (p = .016) and SAVI-mini devices (p < .001). PTV and D _max Rib showed a weak negative relationship in multi-lumen applicators (p = .009), SAVI devices (p < .001), and SAVI-mini devices (p < .001).

Conclusion

PTV volume is strongly correlated with V ₁₅₀in all devices and V ₂₀₀in strut based devices. Larger PTV volumes result in greater V ₁₅₀and V ₂₀₀ , which could help predict potential risks for hotspots and resulting toxicities in these devices. PTV volume is also weakly negatively correlated with max skin dose and max rib dose, meaning that as the PTV volumes increase one can expect slightly smaller max skin and rib doses. Strut based applicators are significantly more effective in keeping skin and rib dose constraints under 125 and 100 % when compared to any balloon based applicator.

【 授权许可】

   
2015 Rana et al.

【 图 表 】

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