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Dosimetric experience with accelerated partial breast irradiation using image-guided interstitial brachytherapy.

Tibor Major1, Georgina Fröhlich, Katalin Lövey

  • 1Department of Radiotherapy, National Institute of Oncology, Budapest, Hungary. major@oncol.hu

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
|November 27, 2007
PubMed
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Image-guided high-dose-rate interstitial brachytherapy for breast cancer shows acceptable dosimetric results. This partial-breast irradiation technique provides good target coverage and dose homogeneity, ensuring patient safety.

Area of Science:

  • Oncology
  • Radiation Oncology
  • Medical Physics

Background:

  • Partial-breast irradiation (PBI) is an alternative to whole-breast irradiation for early-stage breast cancer.
  • High-dose-rate (HDR) brachytherapy offers precise radiation delivery.
  • Image-guided techniques enhance accuracy in radiation therapy planning and delivery.

Purpose of the Study:

  • To evaluate the dosimetric outcomes of image-guided HDR interstitial brachytherapy for early-stage breast cancer.
  • To assess target volume coverage, dose homogeneity, and conformality.
  • To determine the dose delivered to organs at risk.

Main Methods:

  • Retrospective analysis of 28 patients with early-stage breast cancer treated with interstitial PBI.
  • CT imaging for target volume definition and catheter placement planning before implantation.

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  • Post-implant CT scanning for dose planning and optimization.
  • Quantitative dosimetry performed on the planning target volume (PTV) and critical structures.

    • Main Results:

    • The PTV received an average of 91% of the reference dose, with good conformality (index 0.68).
    • Dose non-uniformity ratio was 0.33 and dose homogeneity index was 0.64.
    • Mean maximum doses to skin, lung, and heart were 53%, 42%, and 21%, respectively.

    Conclusions:

    • Image-guided HDR interstitial brachytherapy provides acceptable dosimetric results for early-stage breast cancer.
    • The technique ensures adequate target coverage, dose homogeneity, and conformality.
    • The observed doses to organs at risk are within acceptable limits.