Logo image
Back
A Comprehensive Analysis of Cardiac Dose in Balloon-Based High-Dose-Rate Brachytherapy for Left-Sided Breast Cancer
Journal article

A Comprehensive Analysis of Cardiac Dose in Balloon-Based High-Dose-Rate Brachytherapy for Left-Sided Breast Cancer

Vladimir Valakh, Yongbok Kim, E. Day Werts and Mark G. Trombetta
International journal of radiation oncology, biology, physics, v 82(5), pp 1698-1705
01 Apr 2012
DOI: https://doi.org/10.1016/j.ijrobp.2011.02.058
PMID: 21601371
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Balloon Cardiac dose Contura Heart High-dose-rate brachytherapy MammoSite
To investigate radiation dose to the heart in 60 patients with left-sided breast cancer who were treated with balloon-based high-dose-rate brachytherapy using MammoSite or Contura applicators. We studied 60 consecutive women with breast cancer who were treated with 34 Gy in 10 twice-daily fractions using MammoSite (n = 37) or Contura (n = 23) applicators. The whole heart and the left and right ventricles were retrospectively delineated, and dose–volume histograms were analyzed. Multiple dosimetrics were reported, such as mean dose (Dmean); relative volume receiving 1.7, 5, 10, and 20 Gy (V1.7, V5, V10, and V20, respectively); dose to 1 cc (D1cc); and maximum point dose (Dmax). Biologic metrics, biologically effective dose and generalized equivalent uniform dose were computed. The impact of lumpectomy cavity location on cardiac dose was investigated. The average ± standard deviation of Dmean was 2.45 ± 0.94 Gy (range, 0.56–4.68) and 3.29 ± 1.28 Gy (range, 0.77–6.35) for the heart and the ventricles, respectively. The average whole heart V5 and V10 values were 10.2% and 1.3%, respectively, and the heart Dmax was >20 Gy in 7 of 60 (11.7%) patients and >25 Gy in 3 of 60 (5%) patients. No cardiac tissue received ≥30 Gy. The V1.7, V5, V10, V20, and Dmean values were all higher for the ventricles than for the whole heart. For balloons located in the upper inner quadrant of the breast, the average whole heart Dmean was highest. The Dmean, biologically effective dose, and generalized equivalent uniform dose values for heart and ventricles decreased with increasing minimal distance from the surface of the balloon. On the basis of these comprehensive cardiac dosimetric data, we recommend that cardiac dose be routinely reported and kept as low as possible in balloon-based high-dose-rate brachytherapy treatment planning for patients with left-sided breast cancer so the correlation with future cardiac toxicity data can be investigated.

Metrics

8 Record Views
10 citations in Web of Science
10 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
Web of Science research areas
Oncology
Radiology, Nuclear Medicine & Medical Imaging
Logo image