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Multicatheter interstitial brachytherapy versus stereotactic radiotherapy with CyberKnife for accelerated partial breast irradiation: a comparative treatment planning study with respect to dosimetry of organs at risk

,

Gábor Stelczer

Gábor Stelczer

,

Csilla Pesznyák

Csilla Pesznyák

,

Georgina Fröhlich

Georgina Fröhlich

,

Viktor Smanykó

Viktor Smanykó

,

Norbert Mészáros

Norbert Mészáros

,

oraz

| 25 mar 2021

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Radiology and Oncology

Tom 55 (2021): Zeszyt 2 (June 2021)

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Article Category: Research Article

Data publikacji: 25 mar 2021

Zakres stron: 229 - 239

Otrzymano: 27 sie 2020

Przyjęty: 02 lut 2021

DOI: https://doi.org/10.2478/raon-2021-0016

© 2021 András Herein, Gábor Stelczer, Csilla Pesznyák, Georgina Fröhlich, Viktor Smanykó, Norbert Mészáros, Csaba Polgár, Tibor Major, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Representative DVH-s for multicatheter interstitial brachytherapy (MIBT) (solid line) and CyberKnife (CK) treatment (dashed line) for accelerated partial breast irradiation. The prescribed dose was 25 Gy. The target volume is indicated with red, the non-target breast with yellow, the ipsilateral lung with blue and the heart with orange. The solid red line clearly shows that with MIBT volumes irradiated by high doses (> 25 Gy) develop within the target volume.

Representative dose distribution for multicatheter interstitial brachytherapy (MIBT) (A) and CyberKnife (CK) treatment (B). PTV: red, ipsilateral breast: yellow, contralateral breast: pink, ribs: green, heart: orange, ipsilateral lung: dark blue, contralateral lung: light blue.

Dosimetry of skin and ribs for multicatheter interstitial brachytherapy (MIBT) and CyberKnife (CK) treatments. The values are given in percentages except for V100 and V50

Skin	MIBT	CK	p-value*
D0.1cm³	75.3 (18.0−164.2)	88.8 (27.6−112.4)	0.0080
D0.2cm³	70.3 (17.4−140.7)	86.8 (21.1−111.1)	0.0053
D1cm³	58.4 (15.0−97.1)	79 (22.8−106.0)	0.0007
Ribs
D0.1cm³	53.7 (8.1−92.7)	78.9 (17.6−108.4)	0.0003
D1cm³	43.1 (5.3−76.4)	69.1 (16.4−105)	0.0004
V100 (cm³)	0 (0−0)	0.2 (0.0−3.0)	0.0101
V50 (cm³)	2 (0.0−16.4)	4.2 (0.0−13.4)	0.0105

Tumour localization according to breast quadrants in patients treated by multicatheter interstitial brachytherapy (MIBT) and CyberKnife (CK)

Method of treatment	Laterality	Upper outer	Lower outer	Upper inner	Lower inner	Central
MIBT	right	3	1	3	2	4
MIBT	left	3	3	4	1	8
CK	right	6	6	2	1	2
CK	left	2	4	1	3	5

Dosimetry of ipsilateral breast for multicatheter interstitial brachytherapy (MIBT) and CyberKnife (CK) treatments. The values are given in percentages

	MIBT	CK	p-value*
Whole breast
V100	9.7 (2.2−29.7)	9.6 (0.9−20.4)	0.9381
V50	23.2 (5.1−68.0)	23.3 (2.7−47.1)	0.9822
Non-target breast
V100	1.6 (0.4−4.2)	0.7 (0.0−2.0)	< 0.0001
V90	2.8 (0.6−8.1)	2.3 (0.0−4.4)	0.7019
V50	12.9 (3.1−35.4)	10.5 (1.7−18.9)	0.5501
V25	31.8 (9.4−68.4)	29.9 (7.6−55.2)	0.8772

Dosimetry of ipsilateral lung for multicatheter interstitial brachytherapy (MIBT) and CyberKnife (CK) treatments. The values are given in percentages

Ipsilateral lung	MIBT	CK	p-value*
Mean lung dose	4.9 (1.9−11.1)	4.9 (1.6−11.8)	0.9946
D0.1cm³	41.0 (10.1−61.5)	52.2 (15.6−90.5)	0.0068
D1cm³	36.1 (8.7−55.8)	45.4 (14.4−84.5)	0.0162
D2cm³	33.6 (8−52.5)	42.2 (13.7−80.5)	0.0198
D2	21.2 (7.4−32.9)	24 (8.8−46.4)	0.2454
V5	30.6 (5.1−50.0)	30.7 (5.8−63.2)	0.9357

Dosimetry of heart for multicatheter interstitial brachytherapy (MIBT) and CyberKnife (CK) treatments. The values are given in percentages

Heart	MIBT	CK	p-value*
Mean heart dose	4.1 (1.0−7.7)	3.3 (1.3−6.9)	0.1706
D0.1cm³	21.4 (4.0−47.2)	18.9 (8.4−43.2)	0.2822
D1cm³	18.2 (3.2−42.3)	16.6 (7.3−40.3)	0.4878
D2cm³	17 (3.0−40.0)	15.6 (6.8−38.3)	0.5324
D2	13.3 (4.3−26.4)	12.5 (5.2−31.5)	0.5098
V5	29.9 (0.0−62.5)	21.2 (6.1−41.0)	0.1653

Absolute volumes of the body irradiated by 100%, 50% and 20% of the prescribed dose for multicatheter interstitial brachytherapy (MIBT) and CyberKnife (CK) treatments

Body	MIBT	CK	p-value*
V100 (cm³)	66.4 (28.9−193.8)	77.1 (18.3−141.5)	0.0356
V50 (cm³)	159.0 (73.4−444.2)	189.3 (58.6−397.6)	0.0184
V20 (cm³)	470.7 (253.4−1078.1)	609.1 (326.7−1160.8)	0.0013

Dosimetry of contralateral breast and lung for multicatheter interstitial brachytherapy (MIBT) and CyberKnife (CK) treatments. The values are given in percentages

Contralateral breast	MIBT	CK	p-value*
D0.1cm³	4 (0.0−9.8)	2.1 (0.3−11.2)	0.0039
D1cm³	2.6 (0.0−6.4)	1.8 (0.3−9.9)	0.0378
Contralateral lung
D0.1cm³	5.5 (0.0−11.7)	3 (1.0−5.6)	0.0000
D1cm³	3.6 (0.0−8.3)	2.5 (0.6−4.8)	0.0228

Treatment characteristics and mean dosimetric parameters in publications for accelerated partial breast irradiation (APBI) with CyberKnife

Publication	Xu 2012²⁵	Vermeulen 2014⁵¹	Goggin 2015²⁶	Rault 2016²⁷	Obayomi 2016⁵²	Lozza 2018⁵³	Bonfantini 2018²⁸	Lee 2018²⁹	Lee 2020⁵⁴	Fröhlich 2020³⁶	Current study
Patient number	14	21	9	10	10	20	10	10	103	25	32
Applicator	Cones	-	Iris, MLC	Iris	-	Iris	Iris	Cones	-	MLC	MLC
Beam number	-	151	- , -	-	155	180	122	-	-	-	40 (57)^@
Fractionation	10 x 3.85 Gy	10 x 3.4 Gy	5 x 6 Gy	10 x 4 Gy	5 x 6 Gy	6 5 Gy x	5 x 6 Gy	5 x 6 Gy	5 x 6 Gy	4 x 6.25 Gy	4 x 6.25 Gy
Treatment Time (min)	-	46	28, 14.7	40	-	60	60	60	33^#	-	33.3
CTV-PTV margin (mm)	2	2	2	3	5	5	5	2	0	2	2
Mean PTV volume (cm³)	-	114	-	-	70	88.1	121.6	37.7	73.6	71.6	71.7
Ipsilateral breast
V100 (%)	7^#	12	12.5, 12.2		14	28.7		10	-		9.6
V50 (%)	22.4^#	26	25.8, 24.2		31	75		24	35.5^#		23.3
Ipsilateral non-target breast
V100 (%)	9			-			1.7		-		0.7
V50 (%)	23.1			17.6			16.3		-	10.5	10.5
Ipsilateral lung
V30 (%)	1.3		1.9, 1.6			2.3	2.1		2.2^#		1.0
V5 (%)	31.4^#		39.4, 17.9								30.7
mean dose (%)											4.9
D0.1cm³										57.5	52.2
D1cm³										45	45.4
Heart
V5 (%)	9.4	10		3.9	31	14	23.2	23	-		21.2
mean dose (%)									2.3^#		3.3
D0.1cm³										12.1	18.9
D1cm³										10.5	16.6
Skin
Dmax (%)	-	108.8	-	-	106.6	98.2	94.7	103.3	88.7^#	99.6*	88.8*
Contralateral breast
Dmax (%)	1.6	3	-	-	10	-	-	10	2.7^#	3.8*	2.1*

eISSN:: 1581-3207
Język:: Angielski

Częstotliwość wydawania:: 4 razy w roku
Dziedziny czasopisma:: Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology, Radiology

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