Dosimetric Parameters in Partial Breast Irradiation Through Brachytherapy

Abstract 

The objective of this work is to evaluate biological models and dose homogeneity in a new partial breast irradiation method, the MammoSite RTS. The study is based on 11 patients who received the therapy. For each patient, we determined the dose volume distribution delivered to the breast. Based on these data, we estimate some important biological parameters. Eleven patients with early-stage, invasive, ductal breast cancer were treated using MammoSite RTS brachytherapy, which delivers radiation through a balloon placed in the lumpectomy bed. The radiation was provided by an Iridium-192 source, and 340 cGy were delivered per fraction twice daily. We calculated some commonly used dosimetric parameters, and evaluated the biological parameters tumor control probability (TCP) and normal tissue complication probability (NTCP). We also looked for correlations among these parameters. The average equivalent uniform dose (EUD), NTCP, and TCP were 43.66 Gy, 47.95%, and 91.78%, respectively. The coefficient of variation (CV) among the patients was very low for all 3 parameters. Two dose homogeneity indices (DHI and the S-index) are strongly correlated (r = −0.815). The area under the dose-volume histogram (DVH) and the treatment volume (TXV) also showed a strong correlation (r = 0.995, p < 0.0001). A simplified logit Poisson–EUD model is suitable for determining NTCP and TCP. Other factors such as the area under the DVH and dose homogeneity indices are also useful in planning radiotherapy treatments for early breast cancer.

Key Words: Dose homogeneity index, Dose volume histogram, Tumor control probability, Mammosite, Normal tissue complication probability, Tumor control probability