On the feasibility of treating to a 1.5 cm PTV with a commercial single-entry hybrid applicator in APBI breast brachytherapy

Kent A. Gifford, Christopher L. Nelson, Steven M. Kirsner, Kelly D. Kisling, Matthew Ballo, Elizabeth S. Bloom

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: To evaluate and determine whether 30 patients previously treated with the SAVI™ device could have been treated to a PTV-EVAL created with a 1.5 cm expansion. This determination was based upon dosimetric parameters derived from current recommendations and dose-response data. Material and methods: Thirty patients were retrospectively planned with PTV-EVALs generated with a 1.5 cm expansion (PTV-EVAL-1.5). Plans were evaluated based on PTV-EVAL-1.5 coverage (V90, V95, V100), skin and rib maximum doses (0.1 cc maximum dose as a percentage of prescription dose), as well as V150 and V200 for the PTV-EVAL-1.5. The treatment planning goal was to deliver ≥ 90% of the prescribed dose to ≥ 90% of the PTV-EVAL-1.5. Skin and rib maximum doses were to be ≤ 125% of the prescription dose and preferably ≤ 100% of the prescription dose. V150 and V200 were not allowed to exceed 52.5 cc and 21 cc, respectively. Plans not meeting the above criteria were recomputed with a 1.25 cm expanded PTV-EVAL and re-evaluated. Results: Based on the above dose constraints, 30% (9/30) of the patients evaluated could have been treated with a 1.5 cm PTV-EVAL. The breakdown of cases successfully achieving the above dose constraints by applicator was: 0/4 (0%) 6-1, 6/15 (40%) 8-1, and 3/11 (27%) 10-1. For these PTV-EVAL-1.5 plans, median V90% was 90.3%, whereas the maximum skin and rib doses were all less than 115.2% and 117.6%, respectively. The median V150 and V200 volumes were 39.2 cc and 19.3, respectively. The treated PTV-EVAL-1.5 was greater in volume than the PTV-EVAL by 41.7 cc, and 60 cc for the 8-1, and 10-1 applicators, respectively. All remaining plans (17) successfully met the above dose constraints to be treated with a 1.25 cm PTV-EVAL (PTV-EVAL-1.25). For the PTV-EVAL-1.25 plans, V90% was 93.7%, and the maximum skin and rib doses were all less than 109.2% and 102.5%, respectively. The median V150 and V200 volumes were 41.2 cc and 19.3, respectively. The treated PTV-EVAL-1.25 was greater in volume than the PTV-EVAL by 16 cc, 24.9 cc, and 33.5 cc for the 6-1, 8-1 and 10-1 applicators, respectively. Conclusions: It is dosimetrically possible to treat beyond the currently advised 1.0 cm expanded PTV-EVAL. Most patients should be able to be treated with a 1.25 cm PTV-EVAL and a select group with a 1.5 cm PTV-EVAL. Applicator size appears to determine the ability to expand to a 1.5 cm PTV-EVAL, as smaller devices were not as propitious in this regard. Further studies may identify additional patient groups that would benefit from this approach.

Original languageEnglish (US)
Pages (from-to)29-33
Number of pages5
JournalJournal of Contemporary Brachytherapy
Volume4
Issue number1
DOIs
StatePublished - Mar 31 2012
Externally publishedYes

Fingerprint

Brachytherapy
Ribs
Breast
Prescriptions
Skin
Equipment and Supplies

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

On the feasibility of treating to a 1.5 cm PTV with a commercial single-entry hybrid applicator in APBI breast brachytherapy. / Gifford, Kent A.; Nelson, Christopher L.; Kirsner, Steven M.; Kisling, Kelly D.; Ballo, Matthew; Bloom, Elizabeth S.

In: Journal of Contemporary Brachytherapy, Vol. 4, No. 1, 31.03.2012, p. 29-33.

Research output: Contribution to journalArticle

Gifford, Kent A. ; Nelson, Christopher L. ; Kirsner, Steven M. ; Kisling, Kelly D. ; Ballo, Matthew ; Bloom, Elizabeth S. / On the feasibility of treating to a 1.5 cm PTV with a commercial single-entry hybrid applicator in APBI breast brachytherapy. In: Journal of Contemporary Brachytherapy. 2012 ; Vol. 4, No. 1. pp. 29-33.
@article{d2d3b813ccfe42b2a06a86ac8d9a5479,
title = "On the feasibility of treating to a 1.5 cm PTV with a commercial single-entry hybrid applicator in APBI breast brachytherapy",
abstract = "Purpose: To evaluate and determine whether 30 patients previously treated with the SAVI™ device could have been treated to a PTV-EVAL created with a 1.5 cm expansion. This determination was based upon dosimetric parameters derived from current recommendations and dose-response data. Material and methods: Thirty patients were retrospectively planned with PTV-EVALs generated with a 1.5 cm expansion (PTV-EVAL-1.5). Plans were evaluated based on PTV-EVAL-1.5 coverage (V90, V95, V100), skin and rib maximum doses (0.1 cc maximum dose as a percentage of prescription dose), as well as V150 and V200 for the PTV-EVAL-1.5. The treatment planning goal was to deliver ≥ 90{\%} of the prescribed dose to ≥ 90{\%} of the PTV-EVAL-1.5. Skin and rib maximum doses were to be ≤ 125{\%} of the prescription dose and preferably ≤ 100{\%} of the prescription dose. V150 and V200 were not allowed to exceed 52.5 cc and 21 cc, respectively. Plans not meeting the above criteria were recomputed with a 1.25 cm expanded PTV-EVAL and re-evaluated. Results: Based on the above dose constraints, 30{\%} (9/30) of the patients evaluated could have been treated with a 1.5 cm PTV-EVAL. The breakdown of cases successfully achieving the above dose constraints by applicator was: 0/4 (0{\%}) 6-1, 6/15 (40{\%}) 8-1, and 3/11 (27{\%}) 10-1. For these PTV-EVAL-1.5 plans, median V90{\%} was 90.3{\%}, whereas the maximum skin and rib doses were all less than 115.2{\%} and 117.6{\%}, respectively. The median V150 and V200 volumes were 39.2 cc and 19.3, respectively. The treated PTV-EVAL-1.5 was greater in volume than the PTV-EVAL by 41.7 cc, and 60 cc for the 8-1, and 10-1 applicators, respectively. All remaining plans (17) successfully met the above dose constraints to be treated with a 1.25 cm PTV-EVAL (PTV-EVAL-1.25). For the PTV-EVAL-1.25 plans, V90{\%} was 93.7{\%}, and the maximum skin and rib doses were all less than 109.2{\%} and 102.5{\%}, respectively. The median V150 and V200 volumes were 41.2 cc and 19.3, respectively. The treated PTV-EVAL-1.25 was greater in volume than the PTV-EVAL by 16 cc, 24.9 cc, and 33.5 cc for the 6-1, 8-1 and 10-1 applicators, respectively. Conclusions: It is dosimetrically possible to treat beyond the currently advised 1.0 cm expanded PTV-EVAL. Most patients should be able to be treated with a 1.25 cm PTV-EVAL and a select group with a 1.5 cm PTV-EVAL. Applicator size appears to determine the ability to expand to a 1.5 cm PTV-EVAL, as smaller devices were not as propitious in this regard. Further studies may identify additional patient groups that would benefit from this approach.",
author = "Gifford, {Kent A.} and Nelson, {Christopher L.} and Kirsner, {Steven M.} and Kisling, {Kelly D.} and Matthew Ballo and Bloom, {Elizabeth S.}",
year = "2012",
month = "3",
day = "31",
doi = "10.5114/jcb.2012.27949",
language = "English (US)",
volume = "4",
pages = "29--33",
journal = "Journal of Contemporary Brachytherapy",
issn = "1689-832X",
publisher = "Termedia Publishing House Ltd.",
number = "1",

}

TY - JOUR

T1 - On the feasibility of treating to a 1.5 cm PTV with a commercial single-entry hybrid applicator in APBI breast brachytherapy

AU - Gifford, Kent A.

AU - Nelson, Christopher L.

AU - Kirsner, Steven M.

AU - Kisling, Kelly D.

AU - Ballo, Matthew

AU - Bloom, Elizabeth S.

PY - 2012/3/31

Y1 - 2012/3/31

N2 - Purpose: To evaluate and determine whether 30 patients previously treated with the SAVI™ device could have been treated to a PTV-EVAL created with a 1.5 cm expansion. This determination was based upon dosimetric parameters derived from current recommendations and dose-response data. Material and methods: Thirty patients were retrospectively planned with PTV-EVALs generated with a 1.5 cm expansion (PTV-EVAL-1.5). Plans were evaluated based on PTV-EVAL-1.5 coverage (V90, V95, V100), skin and rib maximum doses (0.1 cc maximum dose as a percentage of prescription dose), as well as V150 and V200 for the PTV-EVAL-1.5. The treatment planning goal was to deliver ≥ 90% of the prescribed dose to ≥ 90% of the PTV-EVAL-1.5. Skin and rib maximum doses were to be ≤ 125% of the prescription dose and preferably ≤ 100% of the prescription dose. V150 and V200 were not allowed to exceed 52.5 cc and 21 cc, respectively. Plans not meeting the above criteria were recomputed with a 1.25 cm expanded PTV-EVAL and re-evaluated. Results: Based on the above dose constraints, 30% (9/30) of the patients evaluated could have been treated with a 1.5 cm PTV-EVAL. The breakdown of cases successfully achieving the above dose constraints by applicator was: 0/4 (0%) 6-1, 6/15 (40%) 8-1, and 3/11 (27%) 10-1. For these PTV-EVAL-1.5 plans, median V90% was 90.3%, whereas the maximum skin and rib doses were all less than 115.2% and 117.6%, respectively. The median V150 and V200 volumes were 39.2 cc and 19.3, respectively. The treated PTV-EVAL-1.5 was greater in volume than the PTV-EVAL by 41.7 cc, and 60 cc for the 8-1, and 10-1 applicators, respectively. All remaining plans (17) successfully met the above dose constraints to be treated with a 1.25 cm PTV-EVAL (PTV-EVAL-1.25). For the PTV-EVAL-1.25 plans, V90% was 93.7%, and the maximum skin and rib doses were all less than 109.2% and 102.5%, respectively. The median V150 and V200 volumes were 41.2 cc and 19.3, respectively. The treated PTV-EVAL-1.25 was greater in volume than the PTV-EVAL by 16 cc, 24.9 cc, and 33.5 cc for the 6-1, 8-1 and 10-1 applicators, respectively. Conclusions: It is dosimetrically possible to treat beyond the currently advised 1.0 cm expanded PTV-EVAL. Most patients should be able to be treated with a 1.25 cm PTV-EVAL and a select group with a 1.5 cm PTV-EVAL. Applicator size appears to determine the ability to expand to a 1.5 cm PTV-EVAL, as smaller devices were not as propitious in this regard. Further studies may identify additional patient groups that would benefit from this approach.

AB - Purpose: To evaluate and determine whether 30 patients previously treated with the SAVI™ device could have been treated to a PTV-EVAL created with a 1.5 cm expansion. This determination was based upon dosimetric parameters derived from current recommendations and dose-response data. Material and methods: Thirty patients were retrospectively planned with PTV-EVALs generated with a 1.5 cm expansion (PTV-EVAL-1.5). Plans were evaluated based on PTV-EVAL-1.5 coverage (V90, V95, V100), skin and rib maximum doses (0.1 cc maximum dose as a percentage of prescription dose), as well as V150 and V200 for the PTV-EVAL-1.5. The treatment planning goal was to deliver ≥ 90% of the prescribed dose to ≥ 90% of the PTV-EVAL-1.5. Skin and rib maximum doses were to be ≤ 125% of the prescription dose and preferably ≤ 100% of the prescription dose. V150 and V200 were not allowed to exceed 52.5 cc and 21 cc, respectively. Plans not meeting the above criteria were recomputed with a 1.25 cm expanded PTV-EVAL and re-evaluated. Results: Based on the above dose constraints, 30% (9/30) of the patients evaluated could have been treated with a 1.5 cm PTV-EVAL. The breakdown of cases successfully achieving the above dose constraints by applicator was: 0/4 (0%) 6-1, 6/15 (40%) 8-1, and 3/11 (27%) 10-1. For these PTV-EVAL-1.5 plans, median V90% was 90.3%, whereas the maximum skin and rib doses were all less than 115.2% and 117.6%, respectively. The median V150 and V200 volumes were 39.2 cc and 19.3, respectively. The treated PTV-EVAL-1.5 was greater in volume than the PTV-EVAL by 41.7 cc, and 60 cc for the 8-1, and 10-1 applicators, respectively. All remaining plans (17) successfully met the above dose constraints to be treated with a 1.25 cm PTV-EVAL (PTV-EVAL-1.25). For the PTV-EVAL-1.25 plans, V90% was 93.7%, and the maximum skin and rib doses were all less than 109.2% and 102.5%, respectively. The median V150 and V200 volumes were 41.2 cc and 19.3, respectively. The treated PTV-EVAL-1.25 was greater in volume than the PTV-EVAL by 16 cc, 24.9 cc, and 33.5 cc for the 6-1, 8-1 and 10-1 applicators, respectively. Conclusions: It is dosimetrically possible to treat beyond the currently advised 1.0 cm expanded PTV-EVAL. Most patients should be able to be treated with a 1.25 cm PTV-EVAL and a select group with a 1.5 cm PTV-EVAL. Applicator size appears to determine the ability to expand to a 1.5 cm PTV-EVAL, as smaller devices were not as propitious in this regard. Further studies may identify additional patient groups that would benefit from this approach.

UR - http://www.scopus.com/inward/record.url?scp=84859299095&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84859299095&partnerID=8YFLogxK

U2 - 10.5114/jcb.2012.27949

DO - 10.5114/jcb.2012.27949

M3 - Article

VL - 4

SP - 29

EP - 33

JO - Journal of Contemporary Brachytherapy

JF - Journal of Contemporary Brachytherapy

SN - 1689-832X

IS - 1

ER -