Brown Sheree, McLaughlin Mark, Pope Keith, Haile Kenneth, Hughes Laurie, Israel Philip Z
Department of Radiation Oncology, WellStar Kennestone Hospital, Marietta, GA.
Department of Radiation Oncology, WellStar Kennestone Hospital, Marietta, GA.
Brachytherapy. 2009 Apr-Jun;8(2):227-233. doi: 10.1016/j.brachy.2008.11.013. Epub 2009 Feb 12.
We reviewed our institution's experience treating patients with the Contura Multi-Lumen Balloon (SenoRx, Inc., Irvine, CA) breast brachytherapy catheter to deliver accelerated partial breast irradiation.
Forty-one patients treated with breast-conserving therapy received adjuvant radiation using the Contura catheter (34Gy in 3.4Gy fractions). Thirteen patients had Stage 0, 21 had Stage I, and 7 had Stage II breast cancer. Median followup was 8 months (range, 1-17).
Median, minimum skin spacing was 10mm (range, 2-17). Median, maximum skin doses (% of prescribed dose [PD]) were 99.7 (range, 57.1-124.1). Eight patients were treated with a skin spacing <or=5mm and 2 had a spacing of 2mm. Median, maximum rib doses were 102.6% of PD (10.0-187.7), and the median percentage of the planning target volume for evaluation (PTV_EVAL) receiving 95% of the PD was 98.8 (range, 79.4-107.4). The median volume receiving 200% of the PD was 5.7cc (range, 1.3-9.9). The percentage of patients with excellent/good cosmetic results at 6 months (n=15) and 12 months (n=12) was 100%. Patient tolerance was assessed on a scale 0-10 (0=no pain, 10=requiring narcotic analgesics). In 37 out of 38 patients, pain was graded <or=3 at the time of catheter insertion. Four breast infections (11%) and one transient symptomatic seroma (3%) developed.
Adjuvant accelerated partial breast irradiation using the Contura Multi-Lumen Balloon catheter exhibited similar toxicities to standard single lumen balloon brachytherapy with improvements in dosimetric capabilities (i.e., reduced skin and rib doses and improved PTV_EVAL coverage).
我们回顾了本机构使用Contura多腔球囊（SenoRx公司，加利福尼亚州欧文市）乳腺近距离放射治疗导管为患者提供加速部分乳腺照射的经验。
41例接受保乳治疗的患者使用Contura导管接受辅助放疗（34Gy，每次3.4Gy）。13例为0期，21例为I期，7例为II期乳腺癌。中位随访时间为8个月（范围1 - 17个月）。
皮肤最小间距中位数为10mm（范围2 - 17mm）。皮肤最大剂量中位数（规定剂量[PD]的百分比）为99.7（范围57.1 - 124.1）。8例患者皮肤间距≤5mm，2例间距为2mm。肋骨最大剂量中位数为PD的102.6%（10.0 - 187.7），接受95%PD的计划靶体积评估（PTV_EVAL）的中位数百分比为98.8（范围79.4 - 107.4）。接受200%PD的体积中位数为5.7cc（范围1.3 - 9.9）。6个月时（n = 15）和12个月时（n = 12）美容效果为优/良的患者百分比为100%。采用0 - 10分制评估患者耐受性（0 = 无疼痛，10 = 需要麻醉性镇痛药）。38例患者中有37例在导管插入时疼痛分级≤3级。发生了4例乳腺感染（11%）和1例短暂性有症状血清肿（3%）。
使用Contura多腔球囊导管进行辅助加速部分乳腺照射与标准单腔球囊近距离放射治疗毒性相似，但剂量学能力有所改善（即降低了皮肤和肋骨剂量，改善了PTV_EVAL覆盖范围）。
