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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 Cover

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

Radiology and Oncology
Volume 55 (2021): Issue 2 (June 2021)
By: ,  ,  ,  ,  ,  ,   and    
Open Access
|Mar 2021
Figures & tables

Figures & Tables

Figure 1

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.

Table 1

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

Method of treatmentLateralityUpper outerLower outerUpper innerLower innerCentral
MIBTright31324
left33418
CKright66212
left24135
Table 2

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

BodyMIBTCKp-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

[i] *Mann-Whitney U test

Table 3

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

MIBTCKp-value*
Whole breast
          V1009.7 (2.2−29.7)9.6 (0.9−20.4)0.9381
          V5023.2 (5.1−68.0)23.3 (2.7−47.1)0.9822
Non-target breast
          V1001.6 (0.4−4.2)0.7 (0.0−2.0)< 0.0001
          V902.8 (0.6−8.1)2.3 (0.0−4.4)0.7019
          V5012.9 (3.1−35.4)10.5 (1.7−18.9)0.5501
          V2531.8 (9.4−68.4)29.9 (7.6−55.2)0.8772

[i] *Mann-Whitney U test

Table 4

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

Ipsilateral lungMIBTCKp-value*
Mean lung dose4.9 (1.9−11.1)4.9 (1.6−11.8)0.9946
D0.1cm341.0 (10.1−61.5)52.2 (15.6−90.5)0.0068
D1cm336.1 (8.7−55.8)45.4 (14.4−84.5)0.0162
D2cm333.6 (8−52.5)42.2 (13.7−80.5)0.0198
D221.2 (7.4−32.9)24 (8.8−46.4)0.2454
V530.6 (5.1−50.0)30.7 (5.8−63.2)0.9357

[i] *Mann-Whitney U test

Table 5

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

HeartMIBTCKp-value*
Mean heart dose4.1 (1.0−7.7)3.3 (1.3−6.9)0.1706
D0.1cm321.4 (4.0−47.2)18.9 (8.4−43.2)0.2822
D1cm318.2 (3.2−42.3)16.6 (7.3−40.3)0.4878
D2cm317 (3.0−40.0)15.6 (6.8−38.3)0.5324
D213.3 (4.3−26.4)12.5 (5.2−31.5)0.5098
V529.9 (0.0−62.5)21.2 (6.1−41.0)0.1653

[i] *Mann-Whitney U test

Table 6

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

SkinMIBTCKp-value*
D0.1cm375.3 (18.0−164.2)88.8 (27.6−112.4)0.0080
D0.2cm370.3 (17.4−140.7)86.8 (21.1−111.1)0.0053
D1cm358.4 (15.0−97.1)79 (22.8−106.0)0.0007
Ribs
D0.1cm353.7 (8.1−92.7)78.9 (17.6−108.4)0.0003
D1cm343.1 (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

[i] *Mann-Whitney U test

Table 7

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

Contralateral breastMIBTCKp-value*
D0.1cm34 (0.0−9.8)2.1 (0.3−11.2)0.0039
D1cm32.6 (0.0−6.4)1.8 (0.3−9.9)0.0378
Contralateral lung
D0.1cm35.5 (0.0−11.7)3 (1.0−5.6)0.0000
D1cm33.6 (0.0−8.3)2.5 (0.6−4.8)0.0228

[i] *Mann-Whitney U test

Figure 2

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.

Table 8

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

PublicationXu 201225Vermeulen 201451Goggin 201526Rault 201627Obayomi 201652Lozza 201853Bonfantini 201828Lee 201829Lee 202054Fröhlich 202036Current study
Patient number1421910102010101032532
ApplicatorCones-Iris, MLCIris-IrisIrisCones-MLCMLC
Beam number-151- , --155180122---40 (57)@
Fractionation10 x 3.85 Gy10 x 3.4 Gy5 x 6 Gy10 x 4 Gy5 x 6 Gy6 5 Gy x5 x 6 Gy5 x 6 Gy5 x 6 Gy4 x 6.25 Gy4 x 6.25 Gy
Treatment Time (min)-4628, 14.740-60606033#-33.3
CTV-PTV margin (mm)22235552022
Mean PTV volume (cm3)-114--7088.1121.637.773.671.671.7
Ipsilateral breast
          V100 (%)7#1212.5, 12.21428.710-9.6
          V50 (%)22.4#2625.8, 24.231752435.5#23.3
Ipsilateral non-target breast
          V100 (%)9-1.7-0.7
          V50 (%)23.117.616.3-10.510.5
Ipsilateral lung
          V30 (%)1.31.9, 1.62.32.12.2#1.0
          V5 (%)31.4#39.4, 17.930.7
          mean dose (%)4.9
          D0.1cm357.552.2
          D1cm34545.4
Heart
          V5 (%)9.4103.9311423.223-21.2
          mean dose (%)2.3#3.3
          D0.1cm312.118.9
          D1cm310.516.6
Skin
          Dmax (%)-108.8--106.698.294.7103.388.7#99.6*88.8*
Contralateral breast
          Dmax (%)1.63--10--102.7#3.8*2.1*

[i] * = D0.1cm3; # = median value; @ = segment number in parentheses; CTV = clinical target volume; MLC = multileaf collimator; PTV = planning target volume

DOI: https://doi.org/10.2478/raon-2021-0016 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Journal RSS Feed
Language: English
Page range: 229 - 239
Submitted on: Aug 27, 2020
Accepted on: Feb 2, 2021
Published on: Mar 25, 2021
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
multicatheter interstitial brachytherapy,
CyberKnife,
APBI,
dosimetric comparison
Related subjects:
Medicine,
Clinical medicine,
Radiology

© 2021 András Herein, Gábor Stelczer, Csilla Pesznyák, Georgina Fröhlich, Viktor Smanykó, Norbert Mészáros, Csaba Polgár, Tibor Major, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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