A dosimetric analysis comparing electron beam with the MammoSite brachytherapy applicator for intact breast boost |
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| Authors: | AP Shah JB Strauss MC Kirk SS Chen A Dickler |
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| Institution: | 1. Rush University Medical Center, Department of Radiation Oncology, 1653 West Congress Parkway, Chicago, IL 60612, United States;2. Little Company of Mary Hospital, Department of Radiation Oncology, Evergreen Park, IL 60805, United States;1. Institute of Science, R.T. Road, Civil Lines, Nagpur, India;2. Radiological Physics and Advisory Division, Bhabha Atomic Research Centre, Mumbai, India;3. Ex-D.S.T Fellow, C/o RPAD, BARC, Mumbai, India;4. R.T.M. Nagpur University, Nagpur, India;1. Critical Care Nursing, Beirut Arab University, Lebanon;2. Associate Professor of Medicine, Beirut Arab University, Lebanon;3. Head of Pumonary/Critical Care Medicine, Rafik Hariri University Hospital, Beirut, Lebanon;4. Professor of Emergency and Critical Care Nursing, Alexandria University, Egypt;5. Professor of Emergency and Critical Care Nursing, Faculty of Nursing, Alexandria University, Egypt;1. Institute for Scintillation Materials NAS of Ukraine, 60 Lenin Avenue, Kharkov 61001, Ukraine;2. Universite Claude Bernard Lyon 1, Villeurbanne Cedex 69622, France;1. Physics Department, University of Kashan, Kashan, Islamic Republic of Iran;2. Institute of Nanoscience and Nanotechnology, University of Kashan, Kashan, Islamic Republic of Iran |
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| Abstract: | IntroductionElectron beam radiation is the modality most often used to deliver an operative bed boost to breast cancer patients after completing whole breast radiation. However, electrons can potentially provide inadequate coverage. The MammoSite breast brachytherapy applicator may provide dosimetric advantages in the delivery of an operative bed boost and its role in this setting is not yet defined.Materials and methodsThe study population consisted of 15 patients with early stage breast cancer treated with partial breast irradiation (PBI) using the MammoSite device. For each patient, a theoretical boost plan using electrons and a second theoretical boost plan using the MammoSite applicator were created. To assess the adequacy of each boost plan, the PTV V90, PTV V95, and PTV V100 were calculated. To assess dose to normal tissues, the ipsilateral breast V50, ipsilateral lung V30, and heart V20 were calculated.ResultsThe mean PTV V100 for the MammoSite boost was 95.5%, compared to 77.4% for the electron boost (p < 0.001). The mean PTV V95 was 97.8%, compared to 93.3% for the electron boost (p = 0.02). The mean PTV V90, mean breast V50, mean lung V30, and mean heart V20 were not statistically different for MammoSite compared to electrons.ConclusionsA tumor bed boost using the MammoSite breast brachytherapy applicator provides superior target coverage and delivers similar doses to the ipsilateral breast and lung compared to a boost delivered with electrons. More investigation into the role of balloon brachytherapy in the delivery of a breast boost is warranted. |
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