External beam boost versus interstitial high-dose-rate brachytherapy boost in the adjuvant radiotherapy following breast-conserving therapy in early-stage breast cancer: a dosimetric comparison
Purpose : This study aims to compare the dosimetric data of local tumor’s bed dose escalation (boost) with photon beams (external beam radiation therapy – EBRT) versus high-dose-rate interstitial brachytherapy (HDR-BT) after breast-conserving treatment in women with early-stage breast cancer. Mat...
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| Format: | Article |
| Language: | English |
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Termedia Publishing House
2016-08-01
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| Series: | Journal of Contemporary Brachytherapy |
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| Online Access: | https://www.termedia.pl/External-beam-boost-versus-interstitial-high-dose-rate-brachytherapy-boost-in-the-adjuvant-radiotherapy-following-breast-conserving-therapy-in-early-stage-breast-cancer-a-dosimetric-comparison,54,28242,1,1.html |
| _version_ | 1818278864489545728 |
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| author | Martje Marie Terheyden Corinna Melchert György Kovács |
| author_facet | Martje Marie Terheyden Corinna Melchert György Kovács |
| author_sort | Martje Marie Terheyden |
| collection | DOAJ |
| description | Purpose : This study aims to compare the dosimetric data of local tumor’s bed dose escalation (boost) with photon beams (external beam radiation therapy – EBRT) versus high-dose-rate interstitial brachytherapy (HDR-BT) after breast-conserving treatment in women with early-stage breast cancer.
Material and methods : We analyzed the treatment planning data of 136 irradiated patients, treated between 2006 and 2013, who underwent breast-conserving surgery and adjuvant whole breast irradiation (WBI; 50.4 Gy) and boost (HDR-BT: 10 Gy in one fraction [n = 36]; EBRT: 10 Gy in five fractions [n = 100]). Organs at risk (OAR; heart, ipsilateral lung, skin, most exposed rib segment) were delineated. Dosimetric parameters were calculated with the aid of dose-volume histograms (DVH). A non-parametric test was performed to compare the two different boost forms.
Results : There was no difference for left-sided cancers regarding the maximum dose to the heart (HDR-BT 29.8% vs. EBRT 29.95%, p = 0.34). The maximum doses to the other OAR were significantly lower for HDR-BT (Dmax lung 47.12% vs. 87.7%, p < 0.01; rib 61.17% vs. 98.5%, p < 0.01; skin 57.1% vs. 94.75%, p < 0.01; in the case of right-sided breast irradiation, dose of the heart 6.00% vs. 16.75%, p < 0.01).
Conclusions : Compared to EBRT, local dose escalation with HDR-BT presented a significant dose reduction to the investigated OAR. Only left-sided irradiation showed no difference regarding the maximum dose to the heart. Reducing irradiation exposure to OAR could result in a reduction of long-term side effects. Therefore, from a dosimetric point of view, an interstitial boost complementary to WBI via EBRT seems to be more advantageous in the adjuvant radiotherapy of breast cancer. |
| first_indexed | 2024-12-12T23:24:13Z |
| format | Article |
| id | doaj.art-e3a51ddae18147448d17258926370dc0 |
| institution | Directory Open Access Journal |
| issn | 1689-832X 2081-2841 |
| language | English |
| last_indexed | 2024-12-12T23:24:13Z |
| publishDate | 2016-08-01 |
| publisher | Termedia Publishing House |
| record_format | Article |
| series | Journal of Contemporary Brachytherapy |
| spelling | doaj.art-e3a51ddae18147448d17258926370dc02022-12-22T00:08:09ZengTermedia Publishing HouseJournal of Contemporary Brachytherapy1689-832X2081-28412016-08-018429430010.5114/jcb.2016.6197328242External beam boost versus interstitial high-dose-rate brachytherapy boost in the adjuvant radiotherapy following breast-conserving therapy in early-stage breast cancer: a dosimetric comparisonMartje Marie TerheydenCorinna MelchertGyörgy KovácsPurpose : This study aims to compare the dosimetric data of local tumor’s bed dose escalation (boost) with photon beams (external beam radiation therapy – EBRT) versus high-dose-rate interstitial brachytherapy (HDR-BT) after breast-conserving treatment in women with early-stage breast cancer. Material and methods : We analyzed the treatment planning data of 136 irradiated patients, treated between 2006 and 2013, who underwent breast-conserving surgery and adjuvant whole breast irradiation (WBI; 50.4 Gy) and boost (HDR-BT: 10 Gy in one fraction [n = 36]; EBRT: 10 Gy in five fractions [n = 100]). Organs at risk (OAR; heart, ipsilateral lung, skin, most exposed rib segment) were delineated. Dosimetric parameters were calculated with the aid of dose-volume histograms (DVH). A non-parametric test was performed to compare the two different boost forms. Results : There was no difference for left-sided cancers regarding the maximum dose to the heart (HDR-BT 29.8% vs. EBRT 29.95%, p = 0.34). The maximum doses to the other OAR were significantly lower for HDR-BT (Dmax lung 47.12% vs. 87.7%, p < 0.01; rib 61.17% vs. 98.5%, p < 0.01; skin 57.1% vs. 94.75%, p < 0.01; in the case of right-sided breast irradiation, dose of the heart 6.00% vs. 16.75%, p < 0.01). Conclusions : Compared to EBRT, local dose escalation with HDR-BT presented a significant dose reduction to the investigated OAR. Only left-sided irradiation showed no difference regarding the maximum dose to the heart. Reducing irradiation exposure to OAR could result in a reduction of long-term side effects. Therefore, from a dosimetric point of view, an interstitial boost complementary to WBI via EBRT seems to be more advantageous in the adjuvant radiotherapy of breast cancer.https://www.termedia.pl/External-beam-boost-versus-interstitial-high-dose-rate-brachytherapy-boost-in-the-adjuvant-radiotherapy-following-breast-conserving-therapy-in-early-stage-breast-cancer-a-dosimetric-comparison,54,28242,1,1.htmladjuvant radiotherapy breast cancer dosimetry EBRT HDR brachytherapy (HDR-BT) |
| spellingShingle | Martje Marie Terheyden Corinna Melchert György Kovács External beam boost versus interstitial high-dose-rate brachytherapy boost in the adjuvant radiotherapy following breast-conserving therapy in early-stage breast cancer: a dosimetric comparison Journal of Contemporary Brachytherapy adjuvant radiotherapy breast cancer dosimetry EBRT HDR brachytherapy (HDR-BT) |
| title | External beam boost versus interstitial high-dose-rate brachytherapy boost in the adjuvant radiotherapy following breast-conserving therapy in early-stage breast cancer: a dosimetric comparison |
| title_full | External beam boost versus interstitial high-dose-rate brachytherapy boost in the adjuvant radiotherapy following breast-conserving therapy in early-stage breast cancer: a dosimetric comparison |
| title_fullStr | External beam boost versus interstitial high-dose-rate brachytherapy boost in the adjuvant radiotherapy following breast-conserving therapy in early-stage breast cancer: a dosimetric comparison |
| title_full_unstemmed | External beam boost versus interstitial high-dose-rate brachytherapy boost in the adjuvant radiotherapy following breast-conserving therapy in early-stage breast cancer: a dosimetric comparison |
| title_short | External beam boost versus interstitial high-dose-rate brachytherapy boost in the adjuvant radiotherapy following breast-conserving therapy in early-stage breast cancer: a dosimetric comparison |
| title_sort | external beam boost versus interstitial high dose rate brachytherapy boost in the adjuvant radiotherapy following breast conserving therapy in early stage breast cancer a dosimetric comparison |
| topic | adjuvant radiotherapy breast cancer dosimetry EBRT HDR brachytherapy (HDR-BT) |
| url | https://www.termedia.pl/External-beam-boost-versus-interstitial-high-dose-rate-brachytherapy-boost-in-the-adjuvant-radiotherapy-following-breast-conserving-therapy-in-early-stage-breast-cancer-a-dosimetric-comparison,54,28242,1,1.html |
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