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A PHASE II TRIAL OF BALLOON-CATHETER PARTIAL BREAST BRACHYTHERAPY OPTIMIZATION IN THE TREATMENT OF STAGE 0, I AND IIA BREAST CARCINOMA.

Publication ,  Journal Article
Nath, SK; Chen, ZJ; Rowe, BP; Blitzblau, RC; Aneja, S; Grube, BJ; Horowitz, NR; Weidhaas, JB
Published in: J Radiat Oncol
December 2014

OBJECTIVES: (a) To prospectively determine if multidwell position dose delivery can decrease skin dose and resultant toxicity over single dwell balloon-catheter partial breast irradiation, and (b) to evaluate whether specific skin parameters could be safely used instead of skin-balloon distance alone for predicting toxicity and treatment eligibility. METHODS: A single-arm phase II study using a Simon two-stage design was performed on 28 women with stage 0-II breast cancer. All patients were treated with multiple dwell position balloon-catheter brachytherapy. The primary endpoint was ≥ grade 2 skin toxicity. Initial entry required a balloon-skin distance ≥ 7 mm. Based on the toxicity in the first 16 patients, additional patients were treated irrespective of skin-balloon distance as long as the Dmax to 1 mm skin thickness was < 130%. RESULTS: Compared to the phantom single dwell plans, multidwell planning yielded superior PTV coverage as per median V90, V95 and V100, but had slightly worse V150, V200 and DHI. Dmax to skin was decreased by multidwell planning at multiple skin thicknesses. The most common acute toxicity was grade 1 erythema (57%), and only two patients (7%) developed acute grade 2 toxicity (erythema). Late grade 1 fibrosis was seen in 32%. No patients experienced grade 3, 4, or 5 toxicity. CONCLUSIONS: Multidwell position planning for balloon-catheter brachytherapy results in lower skin doses with equal to superior PTV coverage and an overall low rate of initial skin toxicity. Our data suggest that limiting the Dmax to < 130% to 1 mm thick skin is achievable and results in minimal toxicity.

Duke Scholars

Published In

J Radiat Oncol

DOI

ISSN

1948-7894

Publication Date

December 2014

Volume

3

Issue

4

Start / End Page

371 / 378

Location

Germany
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Nath, S. K., Chen, Z. J., Rowe, B. P., Blitzblau, R. C., Aneja, S., Grube, B. J., … Weidhaas, J. B. (2014). A PHASE II TRIAL OF BALLOON-CATHETER PARTIAL BREAST BRACHYTHERAPY OPTIMIZATION IN THE TREATMENT OF STAGE 0, I AND IIA BREAST CARCINOMA. J Radiat Oncol, 3(4), 371–378. https://doi.org/10.1007/s13566-014-0153-8
Nath, Sameer K., Zhe J. Chen, Bryan P. Rowe, Rachel C. Blitzblau, Sanjay Aneja, Baiba J. Grube, Nina R. Horowitz, and Joanne B. Weidhaas. “A PHASE II TRIAL OF BALLOON-CATHETER PARTIAL BREAST BRACHYTHERAPY OPTIMIZATION IN THE TREATMENT OF STAGE 0, I AND IIA BREAST CARCINOMA.J Radiat Oncol 3, no. 4 (December 2014): 371–78. https://doi.org/10.1007/s13566-014-0153-8.
Nath SK, Chen ZJ, Rowe BP, Blitzblau RC, Aneja S, Grube BJ, et al. A PHASE II TRIAL OF BALLOON-CATHETER PARTIAL BREAST BRACHYTHERAPY OPTIMIZATION IN THE TREATMENT OF STAGE 0, I AND IIA BREAST CARCINOMA. J Radiat Oncol. 2014 Dec;3(4):371–8.
Nath, Sameer K., et al. “A PHASE II TRIAL OF BALLOON-CATHETER PARTIAL BREAST BRACHYTHERAPY OPTIMIZATION IN THE TREATMENT OF STAGE 0, I AND IIA BREAST CARCINOMA.J Radiat Oncol, vol. 3, no. 4, Dec. 2014, pp. 371–78. Pubmed, doi:10.1007/s13566-014-0153-8.
Nath SK, Chen ZJ, Rowe BP, Blitzblau RC, Aneja S, Grube BJ, Horowitz NR, Weidhaas JB. A PHASE II TRIAL OF BALLOON-CATHETER PARTIAL BREAST BRACHYTHERAPY OPTIMIZATION IN THE TREATMENT OF STAGE 0, I AND IIA BREAST CARCINOMA. J Radiat Oncol. 2014 Dec;3(4):371–378.
Journal cover image

Published In

J Radiat Oncol

DOI

ISSN

1948-7894

Publication Date

December 2014

Volume

3

Issue

4

Start / End Page

371 / 378

Location

Germany