Acute Toxicity of High-Dose-Rate Intracavitary Brachytherapy With the MammoSite Applicator in Patients With Early-Stage Breast Cancer

Richards, Gregory M.; Berson, Anthony M.; Rescigno, John; Sanghavi, Seema; Siegel, Beth; Axelrod, Deborah; Bernik, Stephanie F.; Scarpinato, Vincent; Mills, Christopher

doi:10.1245/aso.2004.02.009

Cited by 70 publications

(24 citation statements)

References 29 publications

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“…2 Several radiation-induced skin effects have been reported in the literature for MammoSite treatments. [5][6][7][8][9][10][11][12][13] With the advent of several new intracavitary APBI devices that claim to modify the dose distribution and reduce the exit skin dose, it is particularly important to quantify the actual skin doses received. Most brachytherapy treatment planning systems ͑TPSs͒ calculate dose using the formalism proposed by the American Association of Physicists in Medicine Task Group 43 ͑TG-43͒, which assumes a homogeneous water medium.…”

Section: Introductionmentioning

confidence: 99%

Determination of exit skin dose for intracavitary accelerated partial breast irradiation with thermoluminescent dosimeters

et al. 2010

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Purpose: Intracavitary accelerated partial breast irradiation ͑APBI͒ has become a popular treatment for early stage breast cancer in recent years due to its shortened course of treatment and simplified treatment planning compared to traditional external beam breast conservation therapy. However, the exit dose to the skin is a major concern and can be a limiting factor for these treatments. Most treatment planning systems ͑TPSs͒ currently used for high dose-rate ͑HDR͒ 192Ir brachytherapy overestimate the exit skin dose because they assume a homogeneous water medium and do not account for finite patient dimensions. The purpose of this work was to quantify the TPS overestimation of the exit skin dose for a group of patients and several phantom configurations. Methods: The TPS calculated skin dose for 59 HDR 192 Ir APBI patients was compared to the skin dose measured with LiF:Mg,Ti thermoluminescent dosimeters ͑TLDs͒. Additionally, the TPS calculated dose was compared to the TLD measured dose and the Monte Carlo ͑MC͒ calculated dose for eight phantom configurations. Four of the phantom configurations simulated treatment conditions with no scattering material beyond the point of measurement and the other four configurations simulated the homogeneous scattering conditions assumed by the TPS. Since the calibration TLDs for this work were irradiated with 137 Cs and the experimental irradiations were performed with 192 Ir, experiments were performed to determine the intrinsic energy dependence of the TLDs. Correction factors that relate the dose at the point of measurement ͑center of TLD͒ to the dose at the point of interest ͑basal skin layer͒ were also determined and applied for each irradiation geometry. Results: The TLD intrinsic energy dependence for 192 Ir relative to 137 Cs was 1.041Ϯ 1.78%. The TPS overestimated the exit skin dose by an average of 16% for the group of 59 patients studied, and by 9%-15% for the four phantom setups simulating treatment conditions. For the four phantom setups simulating the conditions assumed by the TPS, the TPS calculated dose agreed well with the TLD and MC results ͑within 3% and 1%, respectively͒. The inverse square geometry correction factor ranged from 1.023 to 1.042, and an additional correction factor of 0.978 was applied to account for the lack of charged particle equilibrium in the TLD and basal skin layer. Conclusions: TPS calculations that assume a homogeneous water medium overestimate the exit skin dose for intracavitary APBI treatments. It is important to determine the actual skin dose received during intracavitary APBI to determine the skin dose-response relationship and establish dose limits for optimal skin sparing. This study has demonstrated that TLDs can measure the skin dose with an expanded uncertainty ͑k =2͒ of 5.6% when the proper corrections are applied.

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Section: Introductionmentioning

confidence: 99%

Determination of exit skin dose for intracavitary accelerated partial breast irradiation with thermoluminescent dosimeters

et al. 2010

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“…Czas obserwacji chorych po brachyterapii śródjamowej typu MammoSite jest znacznie krótszy niż po tradycyjnej brachyterapii śródtkankowej z użyciem wielu aplikatorów i wynosi 1-4 lat, a odsetek wznów miejscowych mieści się w granicach 0-5% [16][17][18][19][20][21][22][23][24]. W największym z badań (Mammosite Registry Trial), obejmującym 1449 chorych, odsetek wznów miejscowych po 5 latach wynosił 3,6% [25].…”

Section: Wyniki Badań Nad Apbi Bez Randomizacjiunclassified

Czy napromienianie części piersi powinno się stać standardowym elementem oszczędzającego leczenia chorych na wczesnego raka piersi? Głos na nie

Niwińska¹

2014

Nowotwory. Journal of Oncology

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“…The positive features of balloonbased breast brachytherapy are well described in the article by Dickler et al (7), but there are some limitations associated with this technique and problems have been noted in early reports. For example, Harper et al (10) described a 13% catheter leak or balloon rupture rate and Richards et al (11), reported a 16% rate of infection. Although these may represent the learning curve associated during an initial experience with a new technique, they still must be compared to the low technical failure and infection rates observed with interstitial breast brachytherapy (12).…”

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confidence: 99%

Balloon breast brachytherapy – Review of current data

Kini¹

2005

Brachytherapy

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Acute Toxicity of High-Dose-Rate Intracavitary Brachytherapy With the MammoSite Applicator in Patients With Early-Stage Breast Cancer

Cited by 70 publications

References 29 publications

Determination of exit skin dose for intracavitary accelerated partial breast irradiation with thermoluminescent dosimeters

Determination of exit skin dose for intracavitary accelerated partial breast irradiation with thermoluminescent dosimeters

Czy napromienianie części piersi powinno się stać standardowym elementem oszczędzającego leczenia chorych na wczesnego raka piersi? Głos na nie

Balloon breast brachytherapy – Review of current data

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