Brown Sheree, McLaughlin Mark, Pope Doyle Keith, Haile Kenneth, Hughes Lorie, Israel Philip Z, Lyden Maureen
Department of Radiation Oncology, WellStar Kennestone Hospital, Marietta, GA, USA.
Brachytherapy. 2011 Jan-Feb;10(1):68-73. doi: 10.1016/j.brachy.2010.01.001.
A comparison of dosimetric findings in 33 patients treated with the Contura multilumen balloon (SenoRx Inc., Irvine, CA) (C-MLB) breast brachytherapy catheter vs. 33 patients treated with the MammoSite (Hologic Inc., Bedford, MA) (MS) at a single institution to deliver accelerated partial breast irradiation (APBI) was performed.
CT-based 3-dimensional planning with dose optimization was completed. APBI treatment of 34Gy in 3.4Gy fractions was delivered. Endpoints analyzed included: (1) The percentage of the prescribed dose (PD) covering the planning target volume (PTV), (2) the maximum skin dose as a percentage of the PD, (3) the maximum rib dose as a percentage of the PD, and (4) the V150 and V200.
The C-MLB was placed more frequently in patients with closer skin spacing (<7mm) and rib spacing (<7mm) than in MS patients (45.5% vs. 12.1%, p=0.0057 and 57.6 vs. 33.3, p=0.0131, respectively). Despite closer skin spacing, the overall median skin dose was significantly lower in C-MLB patients (112% of the PD vs. 134%, p=0.0282). No statistically significant differences in the V150 or V200 were observed. In patients with very limited rib spacing (<4mm), the C-MLB delivered significantly lower rib doses than the MS (144% of the PD vs. 191%, p=0.0107). In all clinical scenarios, coverage of the PTV with the C-MLB was either equal to or significantly better than with the MS (p=0.0024).
The C-MLB catheter produced clinically significant improvements in dosimetric endpoints (e.g., reduced skin and rib doses and improved PTV coverage) in most clinical scenarios.
在单一机构对33例使用Contura多腔球囊（SenoRx公司，加利福尼亚州欧文市）（C-MLB）乳腺近距离放射治疗导管治疗的患者与33例使用MammoSite（Hologic公司，马萨诸塞州贝德福德）（MS）治疗的患者进行剂量学结果比较，以实施加速部分乳腺照射（APBI）。
完成基于CT的三维规划并进行剂量优化。以3.4Gy的分次剂量给予34Gy的APBI治疗。分析的终点包括：（1）覆盖计划靶体积（PTV）的处方剂量（PD）百分比，（2）最大皮肤剂量占PD的百分比，（3）最大肋骨剂量占PD的百分比，以及（4）V150和V200。
与MS患者相比，C-MLB在皮肤间距较近（<7mm）和肋骨间距较近（<7mm）的患者中放置频率更高（分别为45.5%对12.1%，p = 0.0057和57.6对33.3，p = 0.0131）。尽管皮肤间距更近，但C-MLB患者的总体中位皮肤剂量显著更低（PD的112%对134%，p = 0.0282）。在V150或V200方面未观察到统计学显著差异。在肋骨间距非常有限（<4mm）的患者中，C-MLB给予的肋骨剂量显著低于MS（PD的144%对191%，p = 0.0107）。在所有临床情况下，C-MLB对PTV的覆盖与MS相当或显著更好（p = 0.0024）。
在大多数临床情况下，C-MLB导管在剂量学终点方面产生了具有临床意义的改善（例如，降低皮肤和肋骨剂量以及改善PTV覆盖）。
