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Initial clinical experience with multilumen brachytherapy catheters for accelerated partial breast irradiation
Chirag Shah1, Mihai Ghilezan, Douglas Arthur
1Department of Radiation Oncology, Beaumont Cancer Institute/Beaumont Oncology Network, Oakland University William Beaumont School of Medicine, Royal Oak, MI 48073, USA. chirag.shah@beaumont.edu
Brachytherapy
|December 24, 2011
Summary
Multilumen catheters improve target coverage and normal structure doses in accelerated partial breast irradiation (APBI). This new method shows similar toxicity profiles to older devices, even with close proximity of skin and ribs.
Area of Science:
- Radiation Oncology
- Medical Physics
- Oncology
Background:
- Accelerated partial breast irradiation (APBI) is an alternative to whole breast irradiation.
- Multilumen catheters offer a novel approach for delivering APBI.
- Evaluating the dosimetric and toxicity outcomes of multilumen catheters is crucial.
Purpose of the Study:
- To assess the initial clinical experience with multilumen catheters for APBI across three institutions.
- To evaluate the dosimetric improvements achieved using multilumen catheters in APBI.
- To compare outcomes with established APBI guidelines.
Main Methods:
- Retrospective analysis of 62 patients meeting APBI criteria, excluding those in a national trial.
- Treatment planning adhered to National Surgical Adjuvant Breast and Bowel Project B-39/Radiation Therapy Oncology Group 0413 protocol guidelines.
- Toxicities were documented using common toxicity criteria version 3.0.
Main Results:
- Multilumen catheters achieved high planning target volume coverage (V90: 95.4%, V95: 95.2%).
- Median skin and rib doses were within acceptable limits (86.9% and 76.1% of prescription dose, respectively).
- In cases with close skin/rib spacing (<7mm), target coverage remained high, with acceptable doses to organs at risk.
Conclusions:
- Multilumen catheters demonstrate dosimetric advantages for APBI, enhancing target coverage and reducing normal tissue doses.
- The toxicity profile observed with multilumen catheters is comparable to single-lumen devices.
- This technique is effective even in challenging patient anatomies with close proximity of critical structures.
