TY - JOUR
T1 - Multicatheter hybrid breast brachytherapy
T2 - A potential alternative for patients with inadequate skin distance
AU - Beriwal, Sushil
AU - Coon, Devin
AU - Kim, Hayeon
AU - Haley, Marsha
AU - Patel, Rakesh
AU - Das, Rupak
PY - 2008/10
Y1 - 2008/10
N2 - Purpose: The purpose of this study was to determine whether the ClearPath (CP) multicatheter hybrid device was able to achieve acceptable dosimetry in patients in whom the proximity of the breast surgical cavity to the skin precluded treatment with intracavitary MammoSite (MS) brachytherapy. Methods and materials: The study consisted of 11 patients who had the MS catheter placed and who were subsequently not treated due to inadequate skin distance. A phantom scan of the CP multicatheter hybrid device was superimposed on the MS CT scan and a dosimetric comparison was performed. Results: The median MS balloon size, diameter, and minimum skin distance were 40 cc, 4.1 cm, and 5 mm, respectively. The D90, V100, V150, and V200 with MS vs. CP were 95.29% vs. 97.06%, 88.8% vs. 91.3%, 35.7% vs. 38.0%, and 9.4% vs. 9.6%, respectively. The median maximum skin dose was 5.5 Gy vs. 3.9 Gy (p <.0001). The median dose homogeneity index (DHI) was 0.60 vs. 0.59 (p = .09). The median maximum rib, heart, and lung dose were 2.17 Gy vs. 2.18 Gy, 2.17 Gy vs. 2.18 Gy, and 0.50 Gy vs. 0.56 Gy, respectively. Conclusion: The hybrid CP catheter reduced the skin dose significantly without compromising the planning target volume coverage, DHI, or dose to other critical organs. The use of this device has the potential to increase the applicability of accelerated partial breast brachytherapy (APBI) in patients with a surgical cavity close to skin compared with balloon brachytherapy.
AB - Purpose: The purpose of this study was to determine whether the ClearPath (CP) multicatheter hybrid device was able to achieve acceptable dosimetry in patients in whom the proximity of the breast surgical cavity to the skin precluded treatment with intracavitary MammoSite (MS) brachytherapy. Methods and materials: The study consisted of 11 patients who had the MS catheter placed and who were subsequently not treated due to inadequate skin distance. A phantom scan of the CP multicatheter hybrid device was superimposed on the MS CT scan and a dosimetric comparison was performed. Results: The median MS balloon size, diameter, and minimum skin distance were 40 cc, 4.1 cm, and 5 mm, respectively. The D90, V100, V150, and V200 with MS vs. CP were 95.29% vs. 97.06%, 88.8% vs. 91.3%, 35.7% vs. 38.0%, and 9.4% vs. 9.6%, respectively. The median maximum skin dose was 5.5 Gy vs. 3.9 Gy (p <.0001). The median dose homogeneity index (DHI) was 0.60 vs. 0.59 (p = .09). The median maximum rib, heart, and lung dose were 2.17 Gy vs. 2.18 Gy, 2.17 Gy vs. 2.18 Gy, and 0.50 Gy vs. 0.56 Gy, respectively. Conclusion: The hybrid CP catheter reduced the skin dose significantly without compromising the planning target volume coverage, DHI, or dose to other critical organs. The use of this device has the potential to increase the applicability of accelerated partial breast brachytherapy (APBI) in patients with a surgical cavity close to skin compared with balloon brachytherapy.
KW - APBI
KW - ClearPath
KW - MammoSite
UR - http://www.scopus.com/inward/record.url?scp=53349165620&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=53349165620&partnerID=8YFLogxK
U2 - 10.1016/j.brachy.2008.07.003
DO - 10.1016/j.brachy.2008.07.003
M3 - Article
C2 - 18771962
AN - SCOPUS:53349165620
SN - 1538-4721
VL - 7
SP - 301
EP - 304
JO - Brachytherapy
JF - Brachytherapy
IS - 4
ER -