eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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3/2021
vol. 13
 
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abstract:
Original paper

Dosimetric comparison between interstitial brachytherapy and volumetric-modulated arc therapy for tumor bed boost in breast cancer

Kannan Periasamy
1, 2
,
Gunaseelan Karunanithi
2
,
Shamsudheen Cholayil
3
,
Kadambari Dharanipragada
4
,
Vijayprabhu Neelakanadan
2

1.
Department of Radiotherapy, PGIMER, Chandigarh, India
2.
Department of Radiation Oncology, Regional Cancer Centre, JIPMER, Puducherry, India
3.
MVR Cancer Centre, Kozhikode, India
4.
Department of General Surgery, JIPMER, Puducherry, India
J Contemp Brachytherapy 2021; 13, 3: 302–309
Online publish date: 2021/05/14
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Introduction
To dosimetrically compare high-dose-rate interstitial brachytherapy (HDR-BT) with volumetric-modulated arc therapy (VMAT) for tumor bed boost, following breast conservative treatment.

Material and methods
50 patients with early-stage breast cancer who underwent breast conservation surgery, followed by either HDR-BT (n = 25) of 15 Gy in 6 fractions over a period of 3 days, or VMAT dose of 16 Gy in 8 fractions (n = 25) for tumor bed boost, were retrospectively reviewed. All patients received whole breast irradiation of 46 Gy in 23 fractions. Dosimetric parameters for organs at risk (OARs), including ipsilateral and contralateral lungs, heart, contralateral breast, skin, and ribs, were evaluated with the help of dose-volume histograms (DVH).

Results
Heart sparing was similar in both modalities (left-sided breast irradiation, HDR-BT D2cc 20.5% vs. VMAT 30.2%, p-value = 0.243; right-sided breast irradiation, D2cc 6.5% vs. 4.4%, p-value = 0.165). Left-sided cases received higher dose to heart compared to right-sided patients. Interstitial brachytherapy resulted in significantly less dose to contralateral breast (D2cc 4.3% vs. 9.6%, p-value < 0.0001), ipsilateral lung (D2cc 27.6% vs. 73.2%, p-value < 0.0001), contralateral lung (D2cc 4.2% vs. 14.5%, p-value < 0.0001), ribs (D2cc 24.1% vs. 41.2%, p-value < 0.0001), and skin (D2cc 77.3% vs. 95%, p-value < 0.0001).

Conclusions
HDR-BT-based tumor bed boost irradiation results in significantly lower doses to most organs at risk with similar heart sparing compared to VMAT.

keywords:

breast neoplasms, radiotherapy, volumetric-modulated arc therapy, interstitial brachytherapy

 
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