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Title: Evaluation of two intracavitary high-dose-rate brachytherapy devices for irradiating additional and irregularly shaped volumes of breast tissue

Abstract

The SAVI and Contura breast brachytherapy applicators represent 2 recent advancements in brachytherapy technology that have expanded the number of women eligible for accelerated partial breast irradiation in the treatment of early-stage breast cancer. Early clinical experience with these 2 single-entry, multichannel high-dose-rate brachytherapy devices confirms their ease of use and dosimetric versatility. However, current clinical guidelines for SAVI and Contura brachytherapy may result in a smaller or less optimal volume of treated tissue compared with traditional interstitial brachytherapy. This study evaluates the feasibility of using the SAVI and Contura to irradiate larger and irregularly shaped target volumes, approaching what is treatable with the interstitial technique. To investigate whether additional tissue can be treated, 17 patients treated with the SAVI and 3 with the Contura were selected. For each patient, the planning target volume (PTV) was modified to extend 1.1 cm, 1.3 cm, and 1.5 cm beyond the tumor bed cavity. To evaluate dose conformance to an irregularly shaped target volume, 9 patients treated with the SAVI and 3 with the Contura were selected from the original 20 patients. The following asymmetric PTV margin combinations were assessed for each patient: 1.5/0.3, 1.3/0.3, and 1.1/0.3 cm. For all patients, treatment planningmore » was performed, adopting the National Surgical Adjuvant Breast and Bowel Project guidelines, and dosimetric comparisons were made. The 6-1 and 8-1 SAVI devices can theoretically treat a maximal tissue margin of 1.5 cm and an asymmetric PTV with margins ranging from 0.3 to 1.5 cm. The 10-1 SAVI and Contura can treat a maximal margin of 1.3 cm and 1.1 cm, respectively, and asymmetric PTV with margins ranging from 0.3-1.3 cm. Compared with the Contura, the SAVI demonstrated greater dosimetric flexibility. Risk of developing excessive hot spots increased with the size of the SAVI device. Both the SAVI and Contura appear capable of treating >1.0-cm margins and irregularly shaped PTVs. The 6-1 SAVI device demonstrated the greatest versatility in targeting PTVs approaching what is treatable using the interstitial technique.« less

Authors:
; ; ;  [1]
  1. Department of Radiation Oncology and Center for Advanced Radiotherapy Technologies (CART), University of California, San Diego, La Jolla, CA (United States)
Publication Date:
OSTI Identifier:
22130371
Resource Type:
Journal Article
Journal Name:
Medical Dosimetry
Additional Journal Information:
Journal Volume: 37; Journal Issue: 1; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0958-3947
Country of Publication:
United States
Language:
English
Subject:
61 RADIATION PROTECTION AND DOSIMETRY; ASYMMETRY; BRACHYTHERAPY; DOSE RATES; DOSIMETRY; HEALTH HAZARDS; HOT SPOTS; IRRADIATION; MAMMARY GLANDS; NEOPLASMS; PATIENTS; PLANNING; RADIATION DOSES; RECOMMENDATIONS; SURGERY

Citation Formats

Lu, Sharon M., E-mail: sharonlu@ucsd.edu, Scanderbeg, Daniel J., Barna, Patrick, Yashar, William, and Yashar, Catheryn. Evaluation of two intracavitary high-dose-rate brachytherapy devices for irradiating additional and irregularly shaped volumes of breast tissue. United States: N. p., 2012. Web. doi:10.1016/J.MEDDOS.2010.12.005.
Lu, Sharon M., E-mail: sharonlu@ucsd.edu, Scanderbeg, Daniel J., Barna, Patrick, Yashar, William, & Yashar, Catheryn. Evaluation of two intracavitary high-dose-rate brachytherapy devices for irradiating additional and irregularly shaped volumes of breast tissue. United States. https://doi.org/10.1016/J.MEDDOS.2010.12.005
Lu, Sharon M., E-mail: sharonlu@ucsd.edu, Scanderbeg, Daniel J., Barna, Patrick, Yashar, William, and Yashar, Catheryn. 2012. "Evaluation of two intracavitary high-dose-rate brachytherapy devices for irradiating additional and irregularly shaped volumes of breast tissue". United States. https://doi.org/10.1016/J.MEDDOS.2010.12.005.
@article{osti_22130371,
title = {Evaluation of two intracavitary high-dose-rate brachytherapy devices for irradiating additional and irregularly shaped volumes of breast tissue},
author = {Lu, Sharon M., E-mail: sharonlu@ucsd.edu and Scanderbeg, Daniel J. and Barna, Patrick and Yashar, William and Yashar, Catheryn},
abstractNote = {The SAVI and Contura breast brachytherapy applicators represent 2 recent advancements in brachytherapy technology that have expanded the number of women eligible for accelerated partial breast irradiation in the treatment of early-stage breast cancer. Early clinical experience with these 2 single-entry, multichannel high-dose-rate brachytherapy devices confirms their ease of use and dosimetric versatility. However, current clinical guidelines for SAVI and Contura brachytherapy may result in a smaller or less optimal volume of treated tissue compared with traditional interstitial brachytherapy. This study evaluates the feasibility of using the SAVI and Contura to irradiate larger and irregularly shaped target volumes, approaching what is treatable with the interstitial technique. To investigate whether additional tissue can be treated, 17 patients treated with the SAVI and 3 with the Contura were selected. For each patient, the planning target volume (PTV) was modified to extend 1.1 cm, 1.3 cm, and 1.5 cm beyond the tumor bed cavity. To evaluate dose conformance to an irregularly shaped target volume, 9 patients treated with the SAVI and 3 with the Contura were selected from the original 20 patients. The following asymmetric PTV margin combinations were assessed for each patient: 1.5/0.3, 1.3/0.3, and 1.1/0.3 cm. For all patients, treatment planning was performed, adopting the National Surgical Adjuvant Breast and Bowel Project guidelines, and dosimetric comparisons were made. The 6-1 and 8-1 SAVI devices can theoretically treat a maximal tissue margin of 1.5 cm and an asymmetric PTV with margins ranging from 0.3 to 1.5 cm. The 10-1 SAVI and Contura can treat a maximal margin of 1.3 cm and 1.1 cm, respectively, and asymmetric PTV with margins ranging from 0.3-1.3 cm. Compared with the Contura, the SAVI demonstrated greater dosimetric flexibility. Risk of developing excessive hot spots increased with the size of the SAVI device. Both the SAVI and Contura appear capable of treating >1.0-cm margins and irregularly shaped PTVs. The 6-1 SAVI device demonstrated the greatest versatility in targeting PTVs approaching what is treatable using the interstitial technique.},
doi = {10.1016/J.MEDDOS.2010.12.005},
url = {https://www.osti.gov/biblio/22130371}, journal = {Medical Dosimetry},
issn = {0958-3947},
number = 1,
volume = 37,
place = {United States},
year = {Sun Apr 01 00:00:00 EDT 2012},
month = {Sun Apr 01 00:00:00 EDT 2012}
}