Initial radiation experience evaluating early tolerance and toxicities in patients undergoing accelerated partial breast irradiation using the Contura Multi-Lumen Balloon breast brachytherapy catheter

Brachytherapy. 2009 Apr-Jun;8(2):227-233. doi: 10.1016/j.brachy.2008.11.013. Epub 2009 Feb 12.

Abstract

Purpose: We reviewed our institution's experience treating patients with the Contura Multi-Lumen Balloon (SenoRx, Inc., Irvine, CA) breast brachytherapy catheter to deliver accelerated partial breast irradiation.

Methods and materials: Forty-one patients treated with breast-conserving therapy received adjuvant radiation using the Contura catheter (34Gy in 3.4Gy fractions). Thirteen patients had Stage 0, 21 had Stage I, and 7 had Stage II breast cancer. Median followup was 8 months (range, 1-17).

Results: Median, minimum skin spacing was 10mm (range, 2-17). Median, maximum skin doses (% of prescribed dose [PD]) were 99.7 (range, 57.1-124.1). Eight patients were treated with a skin spacing <or=5mm and 2 had a spacing of 2mm. Median, maximum rib doses were 102.6% of PD (10.0-187.7), and the median percentage of the planning target volume for evaluation (PTV_EVAL) receiving 95% of the PD was 98.8 (range, 79.4-107.4). The median volume receiving 200% of the PD was 5.7cc (range, 1.3-9.9). The percentage of patients with excellent/good cosmetic results at 6 months (n=15) and 12 months (n=12) was 100%. Patient tolerance was assessed on a scale 0-10 (0=no pain, 10=requiring narcotic analgesics). In 37 out of 38 patients, pain was graded <or=3 at the time of catheter insertion. Four breast infections (11%) and one transient symptomatic seroma (3%) developed.

Conclusion: Adjuvant accelerated partial breast irradiation using the Contura Multi-Lumen Balloon catheter exhibited similar toxicities to standard single lumen balloon brachytherapy with improvements in dosimetric capabilities (i.e., reduced skin and rib doses and improved PTV_EVAL coverage).

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Brachytherapy / instrumentation*
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / radiotherapy*
  • Breast Neoplasms / surgery
  • Catheterization*
  • Dose-Response Relationship, Radiation
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Humans
  • Mastectomy, Segmental
  • Middle Aged
  • Radiation Tolerance / radiation effects*
  • Radiotherapy Planning, Computer-Assisted / methods*
  • Retrospective Studies
  • Treatment Outcome