PMID- 27544819
OWN - NLM
STAT- MEDLINE
DCOM- 20170530
LR  - 20220316
IS  - 1879-0887 (Electronic)
IS  - 0167-8140 (Linking)
VI  - 122
IP  - 1
DP  - 2017 Jan
TI  - Multicatheter interstitial brachytherapy versus intensity modulated external beam 
      therapy for accelerated partial breast irradiation: A comparative treatment 
      planning study with respect to dosimetry of organs at risk.
PG  - 17-23
LID - S0167-8140(16)31241-5 [pii]
LID - 10.1016/j.radonc.2016.08.003 [doi]
AB  - OBJECTIVE: To dosimetrically compare multicatheter interstitial brachytherapy 
      (MIBT) and intensity modulated radiotherapy (IMRT) for accelerated partial breast 
      irradiation (APBI) with special focus on dose to normal tissues and organs at 
      risk (OAR-s). MATERIAL AND METHODS: Thirty-four patients with early stage breast 
      cancer treated with MIBT were selected for the study. For each patient an 
      additional IMRT treatment plan was created using the same CT data and contours as 
      used in MIBT plans. OAR-s included ipsilateral non-target and contralateral 
      breast, lung of both sides, skin, ribs and heart for left sided lesions. The CTV 
      was created from the outlined lumpectomy cavity with a total margin 
      (surgical+radiation) of 20mm in six main directions. The PTV in IMRT plans was 
      generated from CTV with an addition of isotropic 5mm margin. The prescribed dose 
      was 30.1Gy with 7x4.3Gy fractionation for both techniques. From dose-volume 
      histograms quality parameters including volumes receiving a given dose (e.g. 
      V100, V90, V50) and doses to specified volumes (e.g. D(0.01cm(3)), D(0.1cm(3)), 
      D(1cm(3))) were calculated and compared. RESULTS: Except for high dose, 
      non-target breast received less dose with MIBT. V90 was 3.6% vs. 4.8% and V50 was 
      13.7% vs. 25.5% for MIBT and IMRT, respectively. Ipsilateral lung was spared 
      better with MIBT. Mean lung dose was 5.1% vs. 7.1%, [Formula: see text] was 39.0% 
      vs. 54.3% and V5 was 32.9% vs. 41.7% in favour of MIBT. For left sided lesions 
      the heart was generally irradiated by larger doses with MIBT. Mean heart dose was 
      4.5% vs. 2.0% and [Formula: see text] was 18.3% vs. 19.7%, correspondingly. 
      Volumetric maximal skin doses were similar, but regarding dose to 0.1cm(3) and 
      1cm(3) of most exposed volume MIBT provided significantly less doses (76.6% vs. 
      94.4% and 60.2% vs. 87.8%, respectively). Ribs received less dose with MIBT with 
      values of 45.6% vs. 69.3% for [Formula: see text] and 1.4% vs. 4.2cm(3) for V50. 
      Dose to contralateral breast and lung was low with both techniques. No 
      significant differences were observed in maximal doses, but dose to volumes of 
      0.1cm(3) and 1cm(3) were less with MIBT for both organs. [Formula: see text] was 
      3.2% vs. 6.7% for breast and 3.7% vs. 5.6% for lung with MIBT and IMRT, 
      respectively. CONCLUSIONS: The target volume can be appropriately irradiated by 
      both techniques, but MIBT generally spares normal tissues and organs at risk 
      better than IMRT. Except for the heart, other critical structures receive less 
      doses with brachytherapy. To observe whether these dosimetric findings translate 
      into clinical outcome more studies are needed with assessment of toxicity 
      profiles.
CI  - Copyright (c) 2016 Elsevier Ireland Ltd. All rights reserved.
FAU - Major, Tibor
AU  - Major T
AD  - National Institute of Oncology, Radiotherapy Centre, Budapest, Hungary. 
      Electronic address: major@oncol.hu.
FAU - Stelczer, Gabor
AU  - Stelczer G
AD  - National Institute of Oncology, Radiotherapy Centre, Budapest, Hungary.
FAU - Pesznyak, Csilla
AU  - Pesznyak C
AD  - National Institute of Oncology, Radiotherapy Centre, Budapest, Hungary.
FAU - Meszaros, Norbert
AU  - Meszaros N
AD  - National Institute of Oncology, Radiotherapy Centre, Budapest, Hungary.
FAU - Polgar, Csaba
AU  - Polgar C
AD  - National Institute of Oncology, Radiotherapy Centre, Budapest, Hungary.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20160817
PL  - Ireland
TA  - Radiother Oncol
JT  - Radiotherapy and oncology : journal of the European Society for Therapeutic 
      Radiology and Oncology
JID - 8407192
SB  - IM
MH  - Brachytherapy/*methods
MH  - Breast/*radiation effects
MH  - Breast Neoplasms/*radiotherapy
MH  - Female
MH  - Heart/radiation effects
MH  - Humans
MH  - Lung/radiation effects
MH  - *Organs at Risk/pathology
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/*methods
MH  - Radiotherapy, Intensity-Modulated/*methods
MH  - Skin/pathology
OTO - NOTNLM
OT  - APBI
OT  - Dosimetry
OT  - IMRT
OT  - Multicatheter brachytherapy
EDAT- 2016/08/22 06:00
MHDA- 2017/05/31 06:00
CRDT- 2016/08/22 06:00
PHST- 2016/03/30 00:00 [received]
PHST- 2016/08/01 00:00 [revised]
PHST- 2016/08/01 00:00 [accepted]
PHST- 2016/08/22 06:00 [pubmed]
PHST- 2017/05/31 06:00 [medline]
PHST- 2016/08/22 06:00 [entrez]
AID - S0167-8140(16)31241-5 [pii]
AID - 10.1016/j.radonc.2016.08.003 [doi]
PST - ppublish
SO  - Radiother Oncol. 2017 Jan;122(1):17-23. doi: 10.1016/j.radonc.2016.08.003. Epub 
      2016 Aug 17.