Initial Clinical Experience With the Strut-Adjusted Volume Implant (SAVI) Breast Brachytherapy Device for Accelerated Partial-Breast Irradiation (APBI): First 100 Patients With More Than 1 Year of Follow-Up

Journal Article · Fri Jul 01 00:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.02.018· OSTI ID:21587559

Scanderbeg, Daniel ^[1]; Kuske, Robert ^[2]; Wallace, Anne ^[3]; Zannis, Victor ^[4]; Blair, Sarah ^[3]; Grade, Emily; Swenson, Virginia H ^[5]; Quiet, Coral ^[2]

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1. Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States)
2. Arizona Breast Cancer Specialists, Phoenix, AZ (United States)
3. Department of Surgery, University of California San Diego, La Jolla, CA (United States)
4. Breast Care Center of the Southwest, Phoenix, AZ (United States)
5. Arizona Oncology Services Foundation, Phoenix, AZ (United States)

Purpose: The Strut-Adjusted Volume Implant (SAVI; Cianna Medical, Aliso Viejo, CA) is a multichannel single-entry brachytherapy device designed to allow dose modulation to minimize normal tissue dose while simultaneously maximizing target coverage. This is the first report on the initial 102 patients with nearly 2 years of median follow-up. Methods and Materials: One hundred two patients were treated at two institutions. Data were collected on eligibility and dosimetry and followed for toxicity and recurrence. Results: The median follow-up is 21 months. Overall dosimetry is outstanding (median percent of target volume receiving 90% of the prescription dose was 95.9%, volume of target receiving 150% of the prescription dose was 27.8 mL, and volume of target receiving 200% of the prescription dose was 14.0 cm{sup 3}). No devices were pulled prior to treatment completion. For patients with a skin bridge of less than 7 mm, the maximum median skin dose was 280 cGy (median percent of target volume receiving 90% of the prescription dose was 95.2%, volume of target receiving 150% of the prescription dose was 25.8 cm{sup 3} and volume of target receiving 200% of the prescription dose was 12.7 mL). For patients with both chest wall and skin of less than 7 mm, the maximum median lung dose was 205 cGy with simultaneous skin dose of 272 cGy. The rate of telangiectasia was 1.9%. Grade 1 hyperpigmentation developed in 10 patients (9.8%) and Grade 2 fibrosis in 2 patients (1.9%). There were 2 symptomatic seromas and 2 cases of asymptomatic fat necrosis (1.9%). Of the patients, 27% were not eligible for MammoSite balloon brachytherapy (Hologic, Inc., Marlborough, MA) and 5% were not eligible for any balloon brachytherapy. The recurrence rate was 1%. Conclusions: The SAVI appears to safely allow an increase in eligibility for APBI over balloon brachytherapy or three-dimensional conformal radiation, highlighting the outstanding device flexibility to maximize the target dose and minimize the normal tissue dose. The device was well tolerated by patients.

• OSTI ID: 21587559
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 80, Issue 3; Other Information: DOI: 10.1016/j.ijrobp.2010.02.018; PII: S0360-3016(10)00252-X; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BRACHYTHERAPY
CHEST
DOSIMETRY
FIBROSIS
LUNGS
MAMMARY GLANDS
NECROSIS
NEOPLASMS
RADIATION DOSES
RADIATION SOURCE IMPLANTS
SKIN
BODY
DISEASES
DOSES
GLANDS
IMPLANTS
MEDICINE
NUCLEAR MEDICINE
ORGANS
PATHOLOGICAL CHANGES
RADIATION SOURCES
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
THERAPY