Brachytherapy
Volume 7, Issue 4 , Pages 301-304, October 2008

Multicatheter hybrid breast brachytherapy: A potential alternative for patients with inadequate skin distance•

  • Sushil Beriwal

      Affiliations

    • Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA
    • Corresponding Author InformationCorresponding author. Department of Radiation Oncology, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213. Tel.: +1-412-641-4600; fax: +1-412-641-1971.
    • ,
  • Devin Coon

      Affiliations

    • Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA
    • ,
  • Hayeon Kim

      Affiliations

    • Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA
    • ,
  • Marsha Haley

      Affiliations

    • Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA
    • ,
  • Rakesh Patel

      Affiliations

    • Department of Human Oncology, University of Wisconsin, Madison, WI
    • ,
  • Rupak Das

      Affiliations

    • Department of Human Oncology, University of Wisconsin, Madison, WI

Received 29 April 2008; received in revised form 2 July 2008; accepted 16 July 2008. published online 04 September 2008.

Abstract 

Purpose

The purpose of this study was to determine whether the ClearPath (CP) multicatheter hybrid device was able to achieve acceptable dosimetry in patients in whom the proximity of the breast surgical cavity to the skin precluded treatment with intracavitary MammoSite (MS) brachytherapy.

Methods and materials

The study consisted of 11 patients who had the MS catheter placed and who were subsequently not treated due to inadequate skin distance. A phantom scan of the CP multicatheter hybrid device was superimposed on the MS CT scan and a dosimetric comparison was performed.

Results

The median MS balloon size, diameter, and minimum skin distance were 40cc, 4.1cm, and 5mm, respectively. The D90, V100, V150, and V200 with MS vs. CP were 95.29% vs. 97.06%, 88.8% vs. 91.3%, 35.7% vs. 38.0%, and 9.4% vs. 9.6%, respectively. The median maximum skin dose was 5.5Gy vs. 3.9Gy (p <.0001). The median dose homogeneity index (DHI) was 0.60 vs. 0.59 (p=.09). The median maximum rib, heart, and lung dose were 2.17Gy vs. 2.18Gy, 2.17Gy vs. 2.18Gy, and 0.50Gy vs. 0.56Gy, respectively.

Conclusion

The hybrid CP catheter reduced the skin dose significantly without compromising the planning target volume coverage, DHI, or dose to other critical organs. The use of this device has the potential to increase the applicability of accelerated partial breast brachytherapy (APBI) in patients with a surgical cavity close to skin compared with balloon brachytherapy.

Keywords: APBI, MammoSite, ClearPath

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• Disclosure: Sushil Beriwal, MD; Rakesh Patel, MD; and Rupak Das, PhD are members of the ClearPath Advisory Board. ClearPath, North American Scientific (NASI), 20200 Sunburst Street, Chatsworth, CA 91311.

PII: S1538-4721(08)00594-1

doi:10.1016/j.brachy.2008.07.003

Brachytherapy
Volume 7, Issue 4 , Pages 301-304, October 2008

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