Early Clinical Experience with Minisavi APBI Applicator: A Unique Solution for Small Lumpectomy Cavities and Skin Distances

Morcovescu, Serban; Morton, Jeffery D.; Perry, Kyle A.

doi:10.1016/j.ijrobp.2009.07.1636

Cited by 1 publication

(1 citation statement)

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“…Also the skin dose of the patients was 73%-90% of the prescribed dose, which was not possible in case of Mammosite balloon brachytherapy. [ 9 10 ] The Mammosite device has been proven to safely deliver adequate dose to the target tissues in larger breasts with adequate skin sparing, but it does not suit smaller breasts with non-adequate skin margins of less than 5 mm. Patients who are not eligible for Mammosite treatment can be well treated without any compromise on dosimetry.…”

Section: Resultsmentioning

confidence: 99%

Dosimetry evaluation of SAVI-based HDR brachytherapy for partial breast irradiation

et al. 2010

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Accelerated partial breast irradiation (APBI) with high dose rate (HDR) brachytherapy offers an excellent compact course of radiation due to its limited number of fractions for early-stage carcinoma of breast. One of the recent devices is SAVI (strut-adjusted volume implant), which has 6, 8 or 10 peripheral source channels with one center channel. Each channel can be differentially loaded. This paper focuses on the treatment planning, dosimetry and quality assurance aspects of HDR brachytherapy implant with GammaMed Plus HDR afterloader unit. The accelerated PBI balloon devices normally inflate above 35 cc range, and hence these balloon type devices cannot be accommodated in small lumpectomy cavity sizes. CT images were obtained and 3-D dosimetric plans were done with Brachyvision planning system. The 3-D treatment planning and dosimetric data were evaluated with planning target volume (PTV)_eval V90, V95, V150, V200 skin dose and minimum distance to skin. With the use of the SAVI 6-1 mini device, we were able to accomplish an excellent coverage — V90, V95, V150 and V200 to 98%, 95%, 37 cc (<50 cc volume) and 16 cc (<20 cc volume), respectively. Maximum skin dose was between 73% and 90%, much below the prescribed dose of 34 Gy. The minimum skin distance achieved was 5 to 11 mm. The volume that received 50% of the prescribed radiation dose was found to be lower with SAVI. The multi-channel SAVI-based implants reduced the maximum skin dose to markedly lower levels as compared to other modalities, simultaneously achieving best dose coverage to target volume. Differential-source dwell-loading allows modulation of the radiation dose distribution in symmetric or asymmetric opening of the catheter shapes and is also advantageous in cavities close to chest wall.

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Section: Resultsmentioning

confidence: 99%