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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 4/2021

01-04-2021 | Brachytherapy | Original Article

Cardiac doses of accelerated partial breast irradiation with perioperative multicatheter interstitial brachytherapy

Authors: Veronika Novotná, Igor Sirák, MD, Ph.D., Denisa Pohanková, Pavel Jandík, Linda Kašaová, Jakub Grepl, Petr Paluska, Petr Motyčka, Ahmed Asqar, Lucie Kretzler, Jiří Petera

Published in: Strahlentherapie und Onkologie | Issue 4/2021

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Abstract

Purpose

To quantify mean heart dose (MHD) and doses to the left anterior descending artery (LAD) and left ventricle (LV) in a retrospective series of patients who underwent perioperative accelerated partial breast irradiation with multicatheter interstitial brachytherapy (MIB-APBI).

Methods

Sixty-eight patients with low-risk left breast cancer were treated with MIB-APBI at our institution between 2012 and 2017. Interstitial tubes were inserted during the tumorectomy and sentinel node biopsy and APBI was started 6 days later. The prescribed dose was 34 Gy in 10 fractions (twice a day) to the clinical target volume (CTV). The heart, LAD, and LV were contoured and the distance between each structure and the CTV was measured. The MHD, mean and maximum LAD doses (LAD mean/max), and mean LV doses (LV mean) were calculated and corrected to biologically equivalent doses in 2‑Gy fractionation (EQD2). We also evaluated the impact of the distance between the cardiac structures and the CTV and of the volume receiving the prescribed dose (V100) and high-dose volume (V150) on heart dosimetry.

Results

Mean EQD2 for MHD, LAD mean/max, and mean LV were 0.9 ± 0.4 Gy (range 0.3–2.2), 1.6 ± 1.1 Gy (range, 0.4–5.6), 2.6 ± 1.9 Gy (range, 0.7–9.2), and 1.3 ± 0.6 Gy (range, 0.5–3.4), respectively. MHD, LAD mean/max, and LV mean significantly correlated with the distance between the CTV and these structures, but all doses were below the recommended limits (German Society of Radiation Oncology; DEGRO). The MHD and LV mean were significantly dependent on V100.

Conclusion

Perioperative MIB-APBI resulted in low cardiac doses in our study. This finding provides further support for the value of this technique in well-selected patients with early-stage left breast cancer.
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Metadata
Title
Cardiac doses of accelerated partial breast irradiation with perioperative multicatheter interstitial brachytherapy
Authors
Veronika Novotná
Igor Sirák, MD, Ph.D.
Denisa Pohanková
Pavel Jandík
Linda Kašaová
Jakub Grepl
Petr Paluska
Petr Motyčka
Ahmed Asqar
Lucie Kretzler
Jiří Petera
Publication date
01-04-2021
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 4/2021
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-020-01699-5

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