A dosimetric comparison of MammoSite® and ClearPath high-dose-rate breast brachytherapy devices

Dickler, Adam; Seif, Neil; Kirk, M.; Patel, Mita; Bernard, Damian; Coon, Alan B.; Dowlatshahi, Kambiz; Das, Rupak K.; Patel, Rakesh

doi:10.1016/j.brachy.2008.07.006

Cited by 20 publications

(17 citation statements)

References 14 publications

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“…To enhance dose-shaping capabilities, several new intracavitary APBI applicators with multiple source channels have been developed. [1][2][3][4] One example is Contura™ ͑SenoRx, Inc., Aliso Viejo, CA͒, which uses a balloon catheter with a central source channel surrounded by four peripheral source channels. 2 Several radiation-induced skin effects have been reported in the literature for MammoSite treatments.…”

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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“…11,[16][17][18][19][20][21] Beyond classical interstitial BT, recently new intracavitary applicators have been developed in the United States to decrease the existing barriers against the widespread use of multicatheter BT. [22][23][24][25] Furthermore, interstitial LDR seed BT has also been implemented as an alternative for stepping-source multicatheter BT. 26 In this article, we will give an overview of the past achievements, current status, and future perspectives of breast BT.…”

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confidence: 99%

Current status and perspectives of brachytherapy for breast cancer

Polgár

Major

2009

Int J Clin Oncol

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Before the era of breast-conserving therapy, brachytherapy implants were used to treat large inoperable breast tumors. In later years, interstitial brachytherapy with rigid needles or multiple flexible catheters has been used to deliver an additional (boost) dose to the tumor bed after breast-conserving surgery and whole-breast irradiation. Reexcision followed by reirradiation using interstitial breast implants has also been implemented as an alternative to mastectomy to treat ipsilateral breast local recurrence after previous breast-conserving therapy. In the past two decades, the new concept of accelerated partial breast irradiation opened a new perspective for breast brachytherapy. The first technique utilized in early accelerated partial breast irradiation studies was multicatheter interstitial brachytherapy. Beyond classical interstitial brachytherapy, recently, new intracavitary applicators have been developed in the United States to decrease the existing barriers against the widespread use of multicatheter brachytherapy. Furthermore, interstitial low-dose-rate seed implants have also been implemented as an alternative for stepping-source multicatheter brachytherapy. In this article, we give an overview of the past achievements, current status, and future perspectives of breast brachytherapy.

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“…The catheter is placed through a single entry point but without the constraints of having a single radiation source. The use of a multicatheter hybrid can reduce doses to the skin and normal tissues in the breast when compared to a single catheter system [18,19,8]. Both highdose-rate as well as low-dose continuous release brachytherapy can be delivered.…”

Section: Cancer Treatment -Conventional and Innovative Approachesmentioning

confidence: 99%

A Review of Radiation Therapy’s Role in Early-Stage Breast Cancer and an Introduction to Electronic Brachytherapy

Herron¹,

Herron²,

Howell³

et al. 2013

Cancer Treatment - Conventional and Innovative Approaches

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A dosimetric comparison of MammoSite® and ClearPath high-dose-rate breast brachytherapy devices

Cited by 20 publications

References 14 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

Current status and perspectives of brachytherapy for breast cancer

A Review of Radiation Therapy’s Role in Early-Stage Breast Cancer and an Introduction to Electronic Brachytherapy

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