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Accelerated partial breast irradiation using external beam radiotherapy-A feasibility study based on dosimetric

Surega Anbumani1, Siddanna R Palled2, Girish S Prabhakar1

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External Beam radiotherapy (EBRT) is a feasible alternative to interstitial brachytherapy for accelerated partial breast irradiation (APBI). This EBRT approach offers comparable tumor coverage and improved normal tissue sparing, demonstrating technical feasibility.

Keywords:
APBIDose conformityDose homogeneityMulticatheter ISBT

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Area of Science:

  • Radiation Oncology
  • Medical Physics

Background:

  • Accelerated Partial Breast Irradiation (APBI) offers reduced treatment duration and irradiated area.
  • Interstitial brachytherapy (ISBT) for APBI is invasive, technique-dependent, and can cause patient discomfort.
  • External Beam Radiotherapy (EBRT) presents a less invasive alternative to ISBT for APBI.

Purpose of the Study:

  • To compare the dosimetric feasibility of EBRT versus ISBT for APBI.
  • To analyze tumor and normal tissue dose-volume parameters for both techniques.
  • To evaluate EBRT as a potential alternative to ISBT for APBI.

Main Methods:

  • CT images of 15 patients undergoing ISBT were used to simulate EBRT plans.
  • Dose-volume histograms (DVHs) were generated for target and organs at risk.
  • Plan quality indices (conformity and homogeneity) were calculated and statistically analyzed.
  • Prescribed doses: 3400 cGy in 10 fractions for ISBT, 3000 cGy in 5 fractions for EBRT with radiobiological correction.

Main Results:

  • EBRT planning achieved comparable tumor dose conformity to ISBT.
  • EBRT demonstrated superior homogeneity in dose distribution.
  • Lower V20 and V5 volumes for lung and heart were observed with EBRT.
  • Statistical analysis indicated a 95% confidence level for using EBRT as an alternative to ISBT.

Conclusions:

  • EBRT planning is technically feasible for APBI in institutions where ISBT is the primary technique.
  • Dosimetric analysis supports EBRT as a viable alternative to ISBT for APBI.
  • EBRT offers potential advantages in normal tissue sparing for APBI.