Clinical and dosimetric experience with MammoSite-based brachytherapy under the RTOG 0413 protocol.
Jadwiga B Wojcicka1, Donette E Lasher1, Ronald Malcom1
1Department of Radiation Oncology, York Cancer Center, York, Pennsylvania, U.S.A.
Journal of Applied Clinical Medical Physics
|May 2, 2008
Summary
MammoSite balloon brachytherapy requires careful planning to meet Radiation Therapy Oncology Group (RTOG) 0413 criteria. Adjustments to implant placement and fluid volume can salvage implants, ensuring optimal partial breast irradiation.
Area of Science:
- Radiation Oncology
- Medical Physics
Background:
- MammoSite balloon brachytherapy is an emerging technique for partial breast irradiation.
- The Radiation Therapy Oncology Group (RTOG) 0413 trial established specific criteria for this treatment.
Purpose of the Study:
- To evaluate the adherence of MammoSite balloon implants to RTOG 0413 criteria.
- To assess the effectiveness of corrective actions for implants not meeting protocol standards.
Main Methods:
- Computed tomography (CT) imaging was used to assess tissue conformance, balloon symmetry, and skin distance.
- Interventions included delayed scanning, balloon manipulation, and fluid volume adjustment.
- Three-dimensional treatment planning and dose-volume histogram analysis evaluated geometric and dosimetric parameters.
Main Results:
- 21.7% of implants initially failed to meet RTOG 0413 acceptance criteria.
- Asymmetry and poor conformance were key factors for non-compliance.
- Interventions successfully corrected all but one non-compliant implant.
Conclusions:
- Rigorous evaluation against RTOG 0413 criteria is crucial for MammoSite brachytherapy.
- Implant manipulation and volume adjustment can salvage implants and ensure protocol compliance.
- These methods optimize partial breast irradiation delivery.
