Wilder Richard B, Curcio Lisa D, Khanijou Rajesh K, Eisner Martin E, Kakkis Jane L, Chittenden Lucy, Agustin Jeffrey, Lizarde Jessica, Mesa Albert V, Ravera John, Tokita Kenneth M
Cancer Center of Irvine, Irvine, CA, USA.
Brachytherapy. 2009 Oct-Dec;8(4):373-8. doi: 10.1016/j.brachy.2009.04.002. Epub 2009 Sep 6.
The purpose of this study was to determine whether a Contura catheter (SenoRx, Inc, Aliso Viejo, CA) can increase the applicability of accelerated partial breast irradiation.
One hundred eighty-two women with early stage breast carcinomas were treated with postlumpectomy brachytherapy using a Contura multilumen catheter (n=45) or a MammoSite single-lumen catheter (Cytyc Corp, Marlborough, MA) (n=137). Hypothetical MammoSite catheter treatment plans were created for the Contura patients. Treatment planning goals were to (1) avoid a radiation "hot spot" in the skin and (2) have only a small air/fluid pocket next to the balloon.
The median followup was 16 months. Eighty-nine percent (40 of 45) of Contura plans satisfied both treatment planning goals vs. only 36% (16 of 45) of MammoSite plans (p<0.0001). A Contura catheter did not require explantation in 16% (7 of 45) of patients where balloon-to-skin spacing was only 3-6mm and 11% (5 of 45) of patients where there was an air/fluid pocket >10% of the planning target volume for plan evaluation (PTV_EVAL). A MammoSite catheter was explanted in 10% of cases where the minimum balloon-to-skin distance was <7mm and in 13% of cases where there was a large air/fluid pocket next to the balloon. Our incidence rates of acute toxicity with a Contura catheter were similar to those with a MammoSite catheter.
A Contura catheter provides important dosimetric advantages over a MammoSite catheter and does not require explantation in cases where balloon-to-skin spacing is only 3-6mm or an air/fluid pocket next to the balloon is >10% of PTV_EVAL.
本研究旨在确定Contura导管（SenoRx公司，加利福尼亚州阿利索维耶霍）是否能提高加速部分乳腺照射的适用性。
182例早期乳腺癌女性患者在乳房肿瘤切除术后接受近距离放射治疗，其中45例使用Contura多腔导管，137例使用MammoSite单腔导管（Cytyc公司，马萨诸塞州马尔伯勒）。为Contura患者制定了假设的MammoSite导管治疗计划。治疗计划目标为：（1）避免皮肤出现放射“热点”；（2）球囊旁仅有小的气/液腔隙。
中位随访时间为16个月。Contura计划的89%（45例中的40例）满足两个治疗计划目标，而MammoSite计划仅为36%（45例中的16例）（p<0.0001）。在球囊与皮肤间距仅为3 - 6mm的患者中，16%（45例中的7例）使用Contura导管无需取出，在计划评估（PTV_EVAL）时气/液腔隙>计划靶体积10%的患者中，11%（45例中的5例）使用Contura导管无需取出。在球囊与皮肤最小距离<7mm的病例中，10%的患者取出了MammoSite导管，在球囊旁有大气/液腔隙的病例中，13%的患者取出了MammoSite导管。Contura导管的急性毒性发生率与MammoSite导管相似。
与MammoSite导管相比，Contura导管具有重要的剂量学优势，在球囊与皮肤间距仅为3 - 6mm或球囊旁气/液腔隙>PTV_EVAL的10%的情况下无需取出。
